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Bruchbacher A, Netsch C, Gross AJ. [First-line treatment of metastatic renal cell carcinoma]. UROLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00120-023-02141-1. [PMID: 37410165 DOI: 10.1007/s00120-023-02141-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 07/07/2023]
Abstract
In recent years the first-line treatment of metastatic renal cell carcinoma was revolutionized by the introduction of checkpoint inhibitors (CPI). Within a few years several combined modality treatments with CPI and tyrosine kinase inhibitors (TKI) have proven to be effective and safe in the application. According to the guidelines, up to five different combined modality treatments can now be considered, depending on the risk profile. Based on the current data situation, a direct distinction between the treatments cannot be made as no comparative studies are available. Therefore, the decision for a particular treatment is often guided by individual factors. In particular, a clear processing of the patient with the respective risk factors and tumor identity is essential. Hence, it is all the more important to discuss complex cases in an interdisciplinary tumor board.
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Affiliation(s)
- Andreas Bruchbacher
- Abteilung für Urologie, Asklepios Klink Barmbek, Rübenkamp, 22307, Hamburg, Deutschland.
| | - Christopher Netsch
- Abteilung für Urologie, Asklepios Klink Barmbek, Rübenkamp, 22307, Hamburg, Deutschland
| | - Andreas J Gross
- Abteilung für Urologie, Asklepios Klink Barmbek, Rübenkamp, 22307, Hamburg, Deutschland
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2
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Zheng J, Li S, Zhao Y, Tao Z, Li L, Li Z, Li M, Chen X. Nomograms for predicting overall and cancer-specific survival of patients with chromophobe renal cell carcinoma after nephrectomy: a retrospective SEER-based study. BMJ Open 2022; 12:e062129. [PMID: 36581979 PMCID: PMC9438212 DOI: 10.1136/bmjopen-2022-062129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE We aimed to construct and validate nomograms to predict overall survival (OS) and cancer-specific survival (CSS) for patients with chromophobe renal cell carcinoma (chRCC) after nephrectomy. DESIGN This study is a retrospective cohort study. SETTING AND PARTICIPANTS There were 2810 patients with chRCC from Surveillance, Epidemiology and End Results database diagnosed between 2010 and 2015 included in the study who were randomly divided into a training cohort (n=1970) and a validation cohort (n=840). Another single-centre external validation cohort containing 124 patients from our hospital was also involved in our study. PRIMARY AND SECONDARY OUTCOME MEASURES OS and CSS. RESULTS Nomograms for OS and CSS include four and five variables, respectively, from the result of least absolute shrinkage and selection operator regression analyses. Nomograms reveal the accurate discrimination by the area under the curve of receiver operating characteristic (ROC) curves and C-indexes, with a C-index value of 0.777 (95% CI 0.728 to 0.826), 0.810 (95% CI 0.747 to 0.873) and 0.863 (95% CI 0.773 to 0.953) for the training cohort, the internal validation cohort and the external validation cohort in the nomogram for OS; and a C-index value of 0.884 (95% CI 0.829 to 0.939), 0.868 (95% CI 0.772 to 0.964) and 0.862 (95% CI 0.760 to 0.964) for the training cohort, the internal validation cohort and the external validation cohort in the nomogram for CSS. It was also proven that there was a high degree of conformance between the predicted and observation results by calibration plots. In addition, the comparison of ROC curves and C-indexes between nomograms and seventh tumour, node and metastasis stage demonstrated that nomograms were better in accuracy and efficacy ability. CONCLUSIONS We successfully constructed two accurate and effective nomograms to predict OS and CSS for patients with chRCC after nephrectomy, which can help clinical doctors choose individual treatment strategies for chRCC patients.
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Affiliation(s)
- Jianyi Zheng
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shijie Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yiqiao Zhao
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zijia Tao
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lei Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zeyu Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Mingyang Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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3
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Al-Danakh A, Safi M, Al-Radhi M, Zhu X, Yang D. Surgery improve overall and cancer-specific survival of rare urinary cancers; population - Based study. Surg Oncol 2022; 44:101807. [DOI: 10.1016/j.suronc.2022.101807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/23/2022] [Accepted: 07/03/2022] [Indexed: 12/23/2022]
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4
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Neves JB, Vanaclocha Saiz L, Abu-Ghanem Y, Marchetti M, Tran-Dang MA, El-Sheikh S, Barod R, Beisland C, Capitanio U, Cullen D, Klatte T, Ljungberg B, Mumtaz F, Patki P, Stewart GD, Dabestani S, Tran MGB, Bex A. Pattern, timing and predictors of recurrence after surgical resection of chromophobe renal cell carcinoma. World J Urol 2021; 39:3823-3831. [PMID: 33851271 DOI: 10.1007/s00345-021-03683-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/24/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Currently there are no specific guidelines for the post-operative follow-up of chromophobe renal cell carcinoma (chRCC). We aimed to evaluate the pattern, location and timing of recurrence after surgery for non-metastatic chRCC and establish predictors of recurrence and cancer-specific death. METHODS Retrospective analysis of consecutive surgically treated non-metastatic chRCC cases from the Royal Free London NHS Foundation Trust (UK, 2015-2019) and the international collaborative database RECUR (15 institutes, 2006-2011). Kaplan-Meier curves were plotted. The association between variables of interest and outcomes were analysed using univariate and multivariate Cox proportional hazards regression models with shared frailty for data source. RESULTS 295 patients were identified. Median follow-up was 58 months. The five and ten-year recurrence-free survival rates were 94.3% and 89.2%. Seventeen patients (5.7%) developed recurrent disease, 13 (76.5%) with distant metastases. 54% of metastatic disease diagnoses involved a single organ, most commonly the bone. Early recurrence (< 24 months) was observed in 8 cases, all staged ≥ pT2b. 30 deaths occurred, of which 11 were attributed to chRCC. Sarcomatoid differentiation was rare (n = 4) but associated with recurrence and cancer-specific death on univariate analysis. On multivariate analysis, UICC/AJCC T-stage ≥ pT2b, presence of coagulative necrosis, and positive surgical margins were predictors of recurrence and cancer-specific death. CONCLUSION Recurrence and death after surgically resected chRCC are rare. For completely excised lesions ≤ pT2a without coagulative necrosis or sarcomatoid features, prognosis is excellent. These patients should be reassured and follow-up intensity curtailed.
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Affiliation(s)
- Joana B Neves
- Division of Surgery and Interventional Science, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | | | - Yasmin Abu-Ghanem
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Marta Marchetti
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - My-Anh Tran-Dang
- Department of Pathology, Royal Free London NHS Foundation Trust, London, UK
| | - Soha El-Sheikh
- Department of Pathology, Royal Free London NHS Foundation Trust, London, UK
| | - Ravi Barod
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Christian Beisland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | - Umberto Capitanio
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - David Cullen
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Tobias Klatte
- Department of Urology, Royal Bournemouth Hospital, Bournemouth, UK
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Börje Ljungberg
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Faiz Mumtaz
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Prasad Patki
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Saeed Dabestani
- Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Maxine G B Tran
- Division of Surgery and Interventional Science, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Axel Bex
- Division of Surgery and Interventional Science, University College London, London, UK.
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK.
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Chen C, Geng X, Liang R, Zhang D, Sun M, Zhang G, Hou J. Nomograms-based prediction of overall and cancer-specific survivals for patients with chromophobe renal cell carcinoma. Exp Biol Med (Maywood) 2020; 246:729-739. [PMID: 33302735 DOI: 10.1177/1535370220977107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This study built and tested two effective nomograms for the purpose of predicting cancer-specific survival and overall survival of chromophobe renal cell carcinoma (chRCC) patients. Multivariate Cox regression analysis was employed to filter independent prognostic factors predictive of cancer-specific survival and overall survival, and the nomograms were built based on a training set incorporating 2901 chRCC patients in a retrospective study (from 2004 to 2015) downloaded from the surveillance, epidemiology, and end results (SEER) database. The nomograms were verified on a validation cohort of 1934 patients, subsequently the performances of the nomograms were examined according to the receiver operating characteristic curve, calibration curves, the concordance (C-index), and decision curve analysis. The results showed that tumor grade, AJCC and N stages, race, marital status, age, histories of chemotherapy, radiotherapy and surgery were the individual prognostic factors for overall survival, and that AJCC, N and SEER stages, histories of surgery, radiotherapy and chemotherapy, age, tumor grade were individual prognostic factors for cancer-specific survival. According to C-indexes, receiver operating characteristic curves, and decision curve analysis outcomes, the nomograms showed a higher accuracy in predicting overall survival and OSS when compared with TNM stage and SEER stage. All the calibration curves were significantly consistent between predictive and validation sets. In this study, the nomograms, which were validated to be highly accurate and applicable, were built to facilitate individualized predictions of the cancer-specific survival and overall survival to patients diagnosed with chRCC between 2004 and 2015.
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Affiliation(s)
- Chunyang Chen
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Xinyu Geng
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Rui Liang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Dongze Zhang
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, People's Republic of China
| | - Meiyun Sun
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, People's Republic of China
| | - Guangbo Zhang
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, People's Republic of China
| | - Jianquan Hou
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
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Predictive Value of the Age-Adjusted Charlson Comorbidity Index for Outcomes After Hepatic Resection of Hepatocellular Carcinoma. World J Surg 2020; 44:3901-3914. [PMID: 32651603 DOI: 10.1007/s00268-020-05686-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed to evaluate the impact of the age-adjusted Charlson comorbidity index (ACCI) on outcomes after hepatic resection for hepatocellular carcinoma (HCC). METHODS We assessed 763 patients who underwent hepatic resection for HCC. The ACCI scores were categorized as follows: ACCI ≤ 5, ACCI = 6, and ACCI ≥ 7. RESULTS A multivariate analysis showed that the odds ratios for postoperative complications in ACCI = 6 and ACCI ≥ 7 groups, with reference to ACCI ≤ 5 group, were 0.71 (p = 0.41) and 4.15 (p < 0.001), respectively. The hazard ratios for overall survival of ACCI = 6 and ACCI ≥ 7 groups, with reference to ACCI ≤ 5 group, were 1.52 (p = 0.023) and 2.45 (p < 0.001), respectively. The distribution of deaths due to HCC-related, liver-related, and other causes was 68.2%, 11.8%, and 20% in ACCI ≤ 5 group, 47.2%, 13.9%, and 38.9% in ACCI = 6 group, and 27.3%, 9.1%, and 63.6% in ACCI ≥ 7 group (p = 0.053; ACCI ≤ 5 vs. = 6, p = 0.19; ACCI = 6 vs. ≥ 7, p < 0.001; ACCI ≤ 5 vs. ≥ 7). In terms of the treatment for HCC recurrence in ACCI ≤ 5, ACCI = 6, and ACCI ≥ 7 groups, adaptation rate of surgical resection was 20.1%, 7.3%, and 11.1% and the rate of palliative therapy was 4.3%, 12.2%, and 22.2%, respectively. CONCLUSIONS The ACCI predicted the short-term and long-term outcomes after hepatic resection of HCC. These findings will help physicians establish a treatment strategy for HCC patients with comorbidities.
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7
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Lu Y, Luo G, Zhu S, Wang X, Chen Y, Dong Z, Wang S, Ma J, Deng H, Wu D, Dong J. The different expression of glycogen phosphorylases in renal clear cell renal carcinoma and chromophobe renal carcinoma. Clin Proteomics 2020; 17:7. [PMID: 32127786 PMCID: PMC7043045 DOI: 10.1186/s12014-020-9270-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/30/2020] [Indexed: 02/07/2023] Open
Abstract
Background The various pathogenesis between Clear cell renal carcinoma (CCRCC) and Chromophobe renal carcinoma (CHRCC) contributes to the different tumor growth rate and metastasis. In this study, we explored the distinct proteomic profiles between these two cancers and found different expression of glycogen phosphorylases in two cancers. Methods We explored novel targets by proteomics. Five CCRCC cases and five CHRCC cases were selected for tandem mass tag-labeling liquid chromatography-mass spectroscopy (LC–MS). Gene ontology and KEGG pathway were applied for bioinformatic analysis. Glycogen phosphorylases were detected by Western blotting. Results CHRCC were younger, more commonly female, and had larger tumors compared to those with CCRCC. 101 differentially expressed proteins (DEPs) in CCRCC and 235 DEPs in CHRCC were detected by LC–MS. It was found that disruption of metabolic pathways, epithelial cell differentiation, and cell response were the common characters for two tumor types. Activation of cell–cell adhesion and oxidation–reduction process stimulate CCRCC growth and epithelial cell differentiation and transferrin transport was involved in CHRCC growth, We also found that oxidative phosphorylation is activated in CHRCC and inhibited in CCRCC. More importantly, we found and confirmed that upregulation of glycogen phosphorylase liver type in CCRCC and glycogen phosphorylase brain type in CHRCC mediated differential glycogenolysis in the two tumor types, which could serve as potential therapeutic targets. Conclusion We found different expression of glycogen phosphorylases in CCRCC and CHRCC by quantitative proteomics, which provides potential therapeutic targets in the future.
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Affiliation(s)
- Yang Lu
- 1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Guangda Luo
- 2Department of Urology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853 China.,Chinese PLA No. 69241, Urumqi, China
| | - Songbiao Zhu
- 3MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing, China
| | - Xu Wang
- 1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Yuling Chen
- 3MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing, China
| | - ZhouHuan Dong
- 1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Shiyu Wang
- 1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Jie Ma
- 5State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing, China
| | - Haiteng Deng
- 3MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing, China
| | - Di Wu
- 1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Jun Dong
- 2Department of Urology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853 China
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Casuscelli J, Becerra MF, Seier K, Manley BJ, Benfante N, Redzematovic A, Stief CG, Hsieh JJ, Tickoo SK, Reuter VE, Coleman JA, Russo P, Ostrovnaya I, Hakimi AA. Chromophobe Renal Cell Carcinoma: Results From a Large Single-Institution Series. Clin Genitourin Cancer 2019; 17:373-379.e4. [PMID: 31326335 DOI: 10.1016/j.clgc.2019.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/15/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate clinical features and prognostic factors in a large single institutional cohort of chromophobe renal cell carcinoma (ChRCC) patients for identification of tumors with the highest metastatic potential. PATIENTS AND METHODS Clinicopathological parameters of all patients with ChRCC diagnosed and surgically treated at Memorial Sloan Kettering Cancer Center between 1990 and 2016 were identified and compared with patients treated for clear-cell renal cell carcinoma (ccRCC) in the same study period using Wilcoxon test for continuous variables and Fisher exact test for categorical variables. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method, log rank test, and Cox proportional hazards regression. RESULTS Four hundred ninety-six patients with ChRCC (10-year RFS, 91.7% and OS, 82.1%) and 3312 patients with ccRCC (10-year RFS, 79.4% and OS, 63.6%) were included in the analysis. Patients with ChRCC were younger (median 59 vs. 61 years; P = .0015), less frequently male (54.8% vs. 66.3%; P < .0001), showed more favorable T stages (T1-2 in 78% vs. 67%; P < .0001) and less frequent sarcomatoid differentiation (1.2 % vs. 4%; P = .0008) and showed lower rates of metastatic development compared with ccRCC patients. Larger tumor size, sarcomatoid differentiation, and higher T-stage are significantly associated with adverse RFS and OS in chromophobe tumors. CONCLUSION ChRCC is more commonly diagnosed in female and younger patients and is associated with a more favorable clinical outcome and a lower propensity for metastatic development than ccRCC. Larger tumors and sarcomatoid differentiation of ChRCC might be considered as risk factors for metastatic development.
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Affiliation(s)
- Jozefina Casuscelli
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - Maria F Becerra
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kenneth Seier
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brandon J Manley
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Nicole Benfante
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Almedina Redzematovic
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - James J Hsieh
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University, St Louis, MO
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Irina Ostrovnaya
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
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Huang H, Qiu Y, Huang G, Zhou X, Zhou X, Luo W. Value of Ferritin Heavy Chain (FTH1) Expression in Diagnosis and Prognosis of Renal Cell Carcinoma. Med Sci Monit 2019; 25:3700-3715. [PMID: 31104064 PMCID: PMC6537665 DOI: 10.12659/msm.914162] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Serum ferritin is a useful tumor marker for renal cell carcinoma (RCC). However, the expression of ferritin heavy chain (FTH1), the main subunit of ferritin, is unclear in primary RCC tissues. In this study, we investigated FTH1 mRNA expression and its diagnostic and prognostic value in RCC. MATERIAL AND METHODS The mRNA expression of FTH1 was analyzed using including Oncomine, Gene Expression Omnibus, and Cancer Genome Atlas datasets, while the protein level of FTH1 was analyzed using the Human Protein Atlas database. The associations between FTH1 and clinicopathologic characteristics and survival time and Cox multivariate survival analysis were analyzed using SPSS 22.0 software. A meta-analysis was performed to assess consistency of FTH1 expression. GO, KEGG, and PPI analyses were used to predict biological functions. RESULTS According to TCGA data, overexpression of FTH1 was detected in 890 RCC tissues (15.2904±0.63157) compared to 129 normal kidney tissues (14.4502±0.51523, p<0.001). Among the clinicopathological characteristics evaluated, patients with increased pathologic T staging, lymph node metastasis, and distant metastasis were significantly associated with higher expression of FTH1. Elevated FTH1 mRNA levels were correlated with worse prognosis of RCC patients. Cox multivariate survival analysis indicated that age, stage, and M stage were predictors of poor prognosis in patients with RCC. CONCLUSIONS Our data suggest that FTH1 expression is an effective prognostic and diagnosis biomarker for RCC.
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Affiliation(s)
- Huimei Huang
- Department of Pathology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Yuyun Qiu
- Department of Pathology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Guilian Huang
- Department of Pathology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Xiaohui Zhou
- Department of Pathology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Xiaoying Zhou
- Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Wenqi Luo
- Department of Pathology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
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Lin TF, Lin WR, Chen M, Dai SH, Sun FJ, Tsai WK, Chiu AW. Compare Fuhrman Nuclear and Chromophobe Tumor Grade on Chromophobe RCC. Open Med (Wars) 2019; 14:336-342. [PMID: 31032425 PMCID: PMC6475770 DOI: 10.1515/med-2019-0032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/25/2019] [Indexed: 11/26/2022] Open
Abstract
Background Chromophobe renal cell carcinoma (chRCC) has a favorable prognosis. Due to irregular nuclei and nuclear pleomorphism, chRCC has a high Fuhrman nuclear grade (FNG). The chromophobe tumor grade (CTG) is a novel three-tier grading system that has been reported to be a better prognosticator than the traditional FNG. We compared the two nuclear grading systems in terms of patients’ clinical outcomes. Patients and Method We performed this retrospective chart review of all patients with chRCC from 2000 to 2017. All pathologic features and CTG and FNG results were re-evaluated. Result Eighteen patients’ records were reviewed with a mean follow-up of 70.6 months. The nuclear grading distribution was as follows: FNG 2, 56%; FNG 3, 39%; FNG 4, 5%; CTG 1, 78%; CTG 2, 17%; and CTG 3, 6%. Only one patient died. This patient had adrenal invasion, lung metastasis, sarcomatoid change and tumor necrosis, and the tumor was graded as FNG 4 and CTG 3. Overall survival was associated with both FNG and CTG. Conclusion Chromophobe RCC was associated with a low rate of cancer-specific death and sarcomatoid differentiation. Both FNG and CTG were associated with overall survival.
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Affiliation(s)
- Tsu-Feng Lin
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wun-Rong Lin
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan
| | - Marcelo Chen
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan
| | - Shuen-Han Dai
- Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Wei-Kung Tsai
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan
| | - Allen W Chiu
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Takai T, Tsujino T, Yoshikawa Y, Inamoto T, Sugito N, Kuranaga Y, Heishima K, Soga T, Hayashi K, Miyata K, Kataoka K, Azuma H, Akao Y. Synthetic miR-143 Exhibited an Anti-Cancer Effect via the Downregulation of K-RAS Networks of Renal Cell Cancer Cells In Vitro and In Vivo. Mol Ther 2019; 27:1017-1027. [PMID: 30930112 PMCID: PMC6520334 DOI: 10.1016/j.ymthe.2019.03.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 02/18/2019] [Accepted: 03/01/2019] [Indexed: 01/13/2023] Open
Abstract
To understand the role of RAS-signaling networks in the pathogenesis of renal cell carcisnoma, we clarified the relationship between miR-143 and RAS. The expression of miR-143 was extremely downregulated in tumor tissues from renal cell carcinoma patients compared with that in the adjacent normal tissues and Caki-1 cells. We developed a synthetic miR-143#12, and we found that the ectopic expression of it inhibited cell growth with autophagy in Caki-1 cells. Also, the expression level of c-Myc was markedly decreased, resulting in the perturbation of cancer-specific energy metabolism by negatively modulating the expression of GLUT1 and the PTBP1/PKMs axis. A partial metabolic shift from glycolysis to oxidative phosphorylation induced autophagy through increasing the intracellular level of reactive oxygen species (ROS). In an in vivo study, the potent anti-tumor activity of polyion complex (PIC)-loaded miR-143#12 (miR-143#12/PIC) was shown by systemic administration of it to Caki-1 cell-xenografted mice. Higher levels of miR-143 were found in both blood and tumor tissues after the systemic administration with miR-143#12/PIC compared to those with lipoplexes in the xenografted mice. These findings indicated that this synthetic miR-143#12 induced a marked growth inhibition by impairing K-RAS-signaling networks in vitro and in vivo.
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Affiliation(s)
- Tomoaki Takai
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan; Department of Urology, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan
| | - Takuya Tsujino
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan; Department of Urology, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan
| | - Yuki Yoshikawa
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan; Department of Urology, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan
| | - Teruo Inamoto
- Department of Urology, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan
| | - Nobuhiko Sugito
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Yuki Kuranaga
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Kazuki Heishima
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Tomoyoshi Soga
- Institute for Advanced Biosciences, Keio University, 246-2 Mizukami, Kakuganji, Tsuruoka, Yamagata 997-0017, Japan
| | - Kotaro Hayashi
- Innovation Center of NanoMedicine, Institute of Industry Promotion-Kawasaki, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan
| | - Kanjiro Miyata
- Department of Materials Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Kazunori Kataoka
- Innovation Center of NanoMedicine, Institute of Industry Promotion-Kawasaki, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan; Policy Alternatives Research Institute, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan
| | - Yukihiro Akao
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan.
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12
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Dong F, Xu L, Peng X, Xu T, Shen Y, Gao F, Wang X, Zhang X, Chen S, Zhang M, Zhong S, Ding Q. Pathologically examining a minimum of three lymph nodes could better determine node negativity in patients with non-metastatic chromophobe renal cell carcinoma. Jpn J Clin Oncol 2018; 48:942-949. [PMID: 30137442 DOI: 10.1093/jjco/hyy121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/03/2018] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the prognostic value of lymph node (LN) involvement for patients with chromophobe renal cell carcinoma (chRCC) and ascertain the minimum number of LNs that need to be pathologically examined to reliably diagnose a patient with node negative chRCC. Methods From 2004 to 2014, non-metastatic chRCC patients receiving radical nephrectomy together with lymphadenectomy were identified from the Surveillance, Epidemiology and End Results (SEER) database. The primary outcome was overall survival (OS). Results Two hundred and forty-six patients received lymph node dissection during the surgery. Of the patients, 24 (10%) had pathologically confirmed positive LN. Multivariate Cox regression model showed that positive LN was an independent unfavorable predictor for OS (HR = 2.83, 95%CI = 1.14-6.98, P = 0.024). More importantly, LN(-) patients with at least three LNs dissected had significantly better OS compared with when 1-2 LNs were examined (P = 0.048). Multivariate analysis confirmed that in LN(-) patients, the examination of three or more LNs could independently predict better OS compared with patients with only 1-2 LNs dissected (HR≥3LNs = 0.362, 95% CI = 0.135-0.972, P = 0.044). Additionally, the likelihood of finding at least one positive LN was significantly higher on dissection of ≥3 LNs compared with examination of 1-2 LNs (15% vs 5%, P = 0.018). Decision curve analysis found a better clinical validity of the '3 LNs examined'-based classification compared with the traditional LN(-)/LN(+) classification. Conclusion The proportion of positive LNs in chRCC was far from neglectable and LN metastasis could independently predict unfavorable OS. We recommended a minimum of three LNs should be pathologically examined in order to reliably determine node negative.
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Affiliation(s)
- Fan Dong
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Liqi Xu
- Department of Urology, No.113 Hospital of PLA, Ningbo, Zhejiang
| | - Xiaoqiong Peng
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Tianyuan Xu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai
| | - Yifan Shen
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Fengbin Gao
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xianjin Wang
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Xiaohua Zhang
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Shanwen Chen
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Minguang Zhang
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Shan Zhong
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
| | - Qiang Ding
- Department of Urology, Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai
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Haddad MM, Schmit GD, Kurup AN, Schmitz JJ, Boorjian SA, Geske J, Thompson RH, Callstrom MR, Atwell TD. Percutaneous Cryoablation of Solitary, Sporadic Renal Cell Carcinoma: Outcome Analysis Based on Clear-Cell versus Papillary Subtypes. J Vasc Interv Radiol 2018; 29:1122-1126. [DOI: 10.1016/j.jvir.2018.02.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/23/2018] [Accepted: 02/25/2018] [Indexed: 12/28/2022] Open
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14
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Jamal M, Taneja K, Arora S, Barod R, Rogers CG, Sanchez J, Gupta NS, Williamson SR. Chromophobe Renal Cell Carcinoma With Retrograde Venous Invasion and Gain of Chromosome 21: Potential Harbingers of Aggressive Clinical Behavior. Int J Surg Pathol 2018; 26:536-541. [DOI: 10.1177/1066896918763948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Occasionally, renal cell carcinoma (RCC) with renal vein extension spreads against the flow of blood within vein branches into the kidney, forming multifocal nodules throughout the renal parenchyma. These foci are not regarded as multiple tumors but rather reverse spread of tumor along the venous system. This intravascular spread has previously been reported in clear cell RCC and RCC unclassified. However, to our knowledge, this has never been reported in chromophobe RCC. Chromophobe RCC is a unique histologic subtype of renal cancer, generally thought to have less aggressive behavior. However, it nonetheless has the potential to undergo sarcomatoid dedifferentiation, which is associated with poor prognosis. We report a unique case of a 65-year-old man with chromophobe RCC (pT3a) showing classic morphology (nonsarcomatoid), yet presenting with retrograde venous invasion and hilar lymph node metastasis at the time of right radical nephrectomy. Fluorescence in situ hybridization revealed gain of chromosome 21 with loss of multiple other chromosomes. Partial hepatectomy was performed to resect metastatic RCC 7 months after nephrectomy, revealing chromophobe RCC with classic morphology. Bone biopsy confirmed skeletal metastases 38 months after initial diagnosis. Although invasion of the renal vein and retrograde venous invasion are characteristically seen in clear cell RCC, this unusual phenomenon may also occur in chromophobe RCC, despite its unique tumor biology. This and gain of chromosome 21, which was postulated to be associated with aggressive behavior in a previous report, were associated with adverse behavior in our patient, who had short-term progression to multi-organ metastatic disease.
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Affiliation(s)
| | | | | | - Ravi Barod
- Henry Ford Health System, Detroit, MI, USA
- Current affiliation: Royal Free London NHS Foundation Trust, London, UK
| | | | | | | | - Sean R. Williamson
- Henry Ford Health System, Detroit, MI, USA
- Wayne State University, Detroit, MI, USA
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15
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Rowe SP, Gorin MA, Solnes LB, Ball MW, Choudhary A, Pierorazio PM, Epstein JI, Javadi MS, Allaf ME, Baras AS. Correlation of 99mTc-sestamibi uptake in renal masses with mitochondrial content and multi-drug resistance pump expression. EJNMMI Res 2017; 7:80. [PMID: 28971329 PMCID: PMC5624857 DOI: 10.1186/s13550-017-0329-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 09/22/2017] [Indexed: 11/23/2022] Open
Abstract
Background 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has recently been explored for the characterization of indeterminate renal masses. As judged by increased intra-tumoral radiotracer uptake, we have previously reported the excellent diagnostic performance characteristics of this test for identifying benign/indolent oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs). In this study, we investigated potential molecular mechanisms underlying the discriminatory ability of 99mTc-sestamibi SPECT/CT for renal masses. Fifty renal masses imaged with 99mTc-sestamibi SPECT/CT prior to surgical resection were evaluated by immunohistochemistry for mitochondrial content and expression of the multi-drug resistance pump 1 (MDR1/P-gp). Immunohistochemical staining was scored semi-quantitatively, and results were compared across renal tumor histologies and correlated with 99mTc-sestamibi uptake. Results In total, 6/6 (100%) and 2/2 (100%) HOCTs demonstrated strong mitochondrial content staining combined with low MDR1 staining. Clear cell renal cell carcinoma showed an opposite pattern with the majority having low mitochondrial (14/26, 54%) and high MDR1 staining (18/26, 69%). Other tumor types were more variable in staining pattern, although the staining pattern reliably predicted 99mTc-sestamibi uptake in almost all tumors except chromophobe renal cell carcinoma. Conclusions Our findings confirm that renal tumors with high mitochondrial content and relatively low MDR pump expression activity accumulate 99mTc-sestamibi and allow for the accurate diagnosis of the benign/indolent tumor class that includes oncocytomas and HOCTs. For masses in which MDR activity outweighs the presence of mitochondria, the tumors appear cold on 99mTc-sestamibi SPECT/CT, allowing for high confidence in the diagnosis of renal cell carcinoma.
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Affiliation(s)
- Steven P Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA. .,The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Michael A Gorin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA.,The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lilja B Solnes
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Mark W Ball
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ajuni Choudhary
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Phillip M Pierorazio
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jonathan I Epstein
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mehrbod S Javadi
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Mohamad E Allaf
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alex S Baras
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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Xie Y, Ma X, Li H, Gao Y, Gu L, Chen L, Zhang X. Prognostic Value of Clinical and Pathological Features in Chinese Patients with Chromophobe Renal Cell Carcinoma: A 10-Year Single-Center Study. J Cancer 2017; 8:3474-3479. [PMID: 29151931 PMCID: PMC5687161 DOI: 10.7150/jca.19953] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/06/2017] [Indexed: 12/31/2022] Open
Abstract
Objective: To evaluate the prognostic significance of clinicopathological features in a large series of Chinese patients with chromophobe renal cell carcinoma (RCC). Materials and Methods: Patients with chromophobe RCC who were treated surgically for renal masses at Chinese PLA General Hospital from 2006 to 2015 were identified. Tissue slides were reviewed to verify diagnoses and collect clinicopathological variables. Cox proportional hazard regression models and the Kaplan-Meier method were performed to evaluate the significance of clinicopathological variables on survival outcomes. Results: A total of 209 patients with chromophobe RCC were enrolled in this study. There were only 13 cancer-specific events, which included 7 local recurrences and 6 metastases. The estimated 5-year and 10-year disease-free survival (DFS) rates were 92.4% and 83.1%, respectively. Univariate analysis indicated that tumor size, 2010 AJCC TNM stage, grade, sarcomatoid differentiation and urinary collecting system invasion were correlated with poor DFS. Multivariate analysis revealed that tumor size, 2010 AJCC TNM stage and grade were independent predictors of DFS. Conclusions: According to this long-term follow-up on a large number of Chinese patients, we found that chromophobe RCC was associated with a very low rate of cancer-specific events (6.2%) and has a better prognosis than clear cell RCC. Tumor size, 2010 AJCC TNM stage and grade were independent prognostic factors in Chinese patients with chromophobe RCC. The presence of these features in a nephrectomy specimen with chromophobe RCC warrants more active surveillance.
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Affiliation(s)
- Yongpeng Xie
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.,School of Medicine, Nankai University, Tianjin, China
| | - Xin Ma
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Hongzhao Li
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Yu Gao
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Liangyou Gu
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Luyao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xu Zhang
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China
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17
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Prognostic Factors for Renal Cell Carcinoma Subtypes Diagnosed According to the 2016 WHO Renal Tumor Classification: a Study Involving 928 Patients. Pathol Oncol Res 2016; 23:689-698. [PMID: 28032311 DOI: 10.1007/s12253-016-0179-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Abstract
The morphotype and grade of renal cell carcinoma (RCC) in 928 nephrectomies were reclassified according to the 2016 WHO classification in order to analyze the distribution and outcomes of RCC subtypes in Hungary, to assess whether microscopic tumor necrosis is an independent prognostic factor in clear cell RCC, and to study whether a two-tiered grading (low/high) for clear cell and papillary RCC provides similar prognostic information to that of the four-tiered ISUP grading system. 83.4% of the cohort were clear cell, 6.9% papillary, 4.5% chromophobe, 2.3% unclassified, 1.1% Xp11 translocation, 1.1% clear cell papillary, 0.3% collecting duct and 0.1% mucinous tubular and spindle cell RCCs. RCC occurred in 16 patients with end-stage kidney disease and none of them displayed features of acquired cystic kidney disease-associated RCC. The 5-year survival rates were as follows: chromophobe 100%, clear cell papillary 100%, clear cell low-grade 96%, papillary type 1 92%, clear cell high-grade 63%, papillary type 2 65%, unclassified 46%, Xp11 translocation 20%, and collecting duct 0%. The 5-year survival rates in low-grade and high-grade papillary RCC were 95% and 59%, respectively. In clear cell RCC, only the grade, the stage and the positive surgical margin proved to be independent prognostic factors statistically. Overall, papillary RCC occurred relatively infrequently; microscopic tumor necrosis in clear cell RCC did not predict the outcome independently of the tumor grading; and the assignment of clear cell and papillary RCCs into low-grade or high-grade tumors was in terms of survival no worse than the ISUP grading.
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