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Pandolfo SD, Marchioni M, Campi R, Amparore D. YAU renal cancer spotlight: is minimally invasive surgery the future of inferior vena cava thrombectomy? Minerva Urol Nephrol 2024; 76:516-518. [PMID: 39051896 DOI: 10.23736/s2724-6051.24.05981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Savio D Pandolfo
- Department of Urology, University of L'Aquila, L'Aquila, Italy -
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy -
| | - Michele Marchioni
- Department of Urology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Riccardo Campi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Urological Robotic Surgery and Renal Transplantation Unit, Careggi Hospital, University of Florence, Florence, Italy
| | - Daniele Amparore
- Urological Robotic Surgery and Renal Transplantation Unit, Careggi Hospital, University of Florence, Florence, Italy
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2
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Wang S, Gao P, Wang X, Duan L, He X, Qu J. Clinical utility of keratin 14 expression measurement in reflecting the tumor properties and prognosis in patients with renal cell carcinoma: a study with long-term follow-up. Int Urol Nephrol 2024; 56:2045-2053. [PMID: 38206525 DOI: 10.1007/s11255-023-03923-4] [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] [Received: 05/07/2023] [Accepted: 05/23/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Keratin 14 (KRT14) is hypothesized to be involved in the pathogenesis of renal cell carcinoma (RCC) based on its tumorigenic role in various cancers and its relationship with the prognosis of other urinary system malignancies. This study aimed to evaluate the correlation of KRT14 with tumor properties and prognosis in RCC patients. METHODS Data from 180 RCC patients who received tumor resection were retrospectively reviewed. The KRT14 was assessed by immunohistochemistry (IHC) staining in tumor tissues and non-tumor tissues. RESULTS KRT14 was insufficiently expressed in both tumor and non-tumor tissues, with median (interquartile range) IHC score of 2.0 (0.0-3.4) and 1.0 (0.0-2.0), respectively. While it was relatively higher in tumor versus non-tumor tissues (P < 0.001). Besides, tumor KRT14 was positively correlated with the pathological grade (P = 0.038), tumor size (P = 0.012), T stage (P = 0.006), and TNM stage (P = 0.018). Interestingly, tumor KRT14 high predicted shorter accumulating recurrence-free survival (RFS) (P = 0.003) and accumulating overall survival (OS) (P = 0.001), which was further verified by the multivariate Cox's regression analysis (both P < 0.05). Furthermore, tumor KRT14 high estimated shorter RFS and OS from the Gene Expression Profiling Interactive Analysis and Human Protein ATLAS databases (all P < 0.05). Subgroup analyses indicated that the correlation of tumor KRT14 with accumulating RFS and accumulating OS was more pronounced in RCC patients with better physical status (such as age < 65 years and better eastern cooperative oncology group performance status) and higher tumor stages (such as higher pathological grade). CONCLUSION High KRT14 in tumor tissue could reflect an advanced tumor features and unsatisfying survival in RCC patients.
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Affiliation(s)
- Shuangyu Wang
- Department of Nephrology, Handan Central Hospital, Handan, 056000, China
| | - Peng Gao
- Department of Traditional Chinese Medicine, Han Mine General Hospital of North China Medical Health Group, Handan, 056000, China
| | - Xiaozhi Wang
- Department of Emergency, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China
| | - Liping Duan
- Department of Nephrology, Handan Central Hospital, Handan, 056000, China
| | - Xinmei He
- Department of Nephrology, Handan Central Hospital, Handan, 056000, China
| | - Juanjuan Qu
- Department of Emergency, Handan Central Hospital, No. 59 Congtai North Road, Handan, 056000, China.
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3
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Katsu A, Yanagi M, Yoshioka M, Motoda N, Takata H, Kono H, Kimata R, Hamasaki T, Kondo Y. Preoperative rapid growth of inferior vena cava tumor thrombus in renal cell carcinoma. IJU Case Rep 2024; 7:230-233. [PMID: 38686075 PMCID: PMC11056267 DOI: 10.1002/iju5.12709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/09/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction We present the case of a rapidly growing inferior vena cava tumor thrombus in renal cell carcinoma. Case presentation We present a case of a 66-year-old woman with right renal cell carcinoma with a tumor thrombus extending 2 cm into the inferior vena cava on an initial Imaging. Radical surgery was performed 6 weeks after the first visit. Intraoperatively, the tumor thrombus was confirmed to have grown near the diaphragm. The tumor was resected using an inferior vena cava clamping just below the diaphragm. The tumor thrombus and renal cell carcinoma were completely removed. There was no recurrence 6 months postoperatively. Conclusion Inferior vena cava tumor thrombus in renal cell carcinoma can grow in a short period, suggesting that preoperative imaging evaluation at the appropriate time is important. Once inferior vena cava tumor thrombus of renal cell carcinoma occurs, surgery should not be delayed unless there is an urgent reason.
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Affiliation(s)
- Akifumi Katsu
- Department of UrologyNippon Medical School Musashikosugi Hospital1‐383, Kosugimachi211‐8533KanagawaJapan
| | - Masato Yanagi
- Department of UrologyNippon Medical School Musashikosugi Hospital1‐383, Kosugimachi211‐8533KanagawaJapan
| | - Masato Yoshioka
- Department of SurgeryNippon Medical School Musashikosugi HospitalKawasakiKanagawaJapan
| | - Norio Motoda
- Department of PathologyNippon Medical School Musashikosugi HospitalKawasakiKanagawaJapan
| | - Hideyuki Takata
- Department of SurgeryNippon Medical School Musashikosugi HospitalKawasakiKanagawaJapan
| | - Hiroyoshi Kono
- Department of UrologyNippon Medical School Musashikosugi Hospital1‐383, Kosugimachi211‐8533KanagawaJapan
| | - Ryoji Kimata
- Department of UrologyNippon Medical School Musashikosugi Hospital1‐383, Kosugimachi211‐8533KanagawaJapan
| | - Tsutomu Hamasaki
- Department of UrologyNippon Medical School Musashikosugi Hospital1‐383, Kosugimachi211‐8533KanagawaJapan
| | - Yukihiro Kondo
- Department of UrologyNippon Medical School HospitalTokyoJapan
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Bertoletti L, Girard P, Élias A, Espitia O, Schmidt J, Couturaud F, Mahé I, Sanchez O. [Translation into French and republication of: "Recurrent venous thromboembolism in anticoagulated cancer patients: diagnosis and treatment"]. Rev Med Interne 2024; 45:289-299. [PMID: 38806295 DOI: 10.1016/j.revmed.2024.05.017] [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] [Received: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 05/30/2024]
Abstract
Patients with cancer are at significantly increased risk of venous thromboembolism (VTE), due both to the impact of malignant disease itself and to the impact of certain anticancer drugs on haemostasis. This is true both for first episode venous thromboembolism and recurrence. The diagnosis and management of VTE recurrence in patients with cancer poses particular challenges, and these are reviewed in the present article, based on a systematic review of the relevant scientific literature published over the last decade. Furthermore, it is uncertain whether diagnostic algorithms for venous thromboembolism, validated principally in untreated non-cancer patients, are also valid in anticoagulated cancer patients: the available data suggests that clinical decision rules and D-dimer testing perform less well in this clinical setting. In patients with cancer, computed tomography pulmonary angiography and venous ultrasound appear to be the most reliable diagnostic tools for diagnosis of pulmonary embolism and deep vein thrombosis respectively. Options for treatment of venous thromboembolism include low molecular weight heparins (at a therapeutic dose or an increased dose), fondaparinux or oral direct factor Xa inhibitors. The choice of treatment should take into account the nature (pulmonary embolism or VTE) and severity of the recurrent event, the associated bleeding risk, the current anticoagulant treatment (type, dose, adherence and possible drug-drug interactions) and cancer progression.
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Affiliation(s)
- L Bertoletti
- Service de médecine vasculaire et thérapeutique, CHU de Saint-Étienne, Inserm, UMR1059, équipe Dysfonction vasculaire et hémostase, université Jean-Monnet, CIC-1408, 42000 Saint-Étienne, France; F-CRIN INNOVTE network, Saint-Étienne, France.
| | - P Girard
- F-CRIN INNOVTE network, Saint-Étienne, France; Institut du thorax Curie-Montsouris, institut mutualiste Montsouris, Paris, France
| | - A Élias
- F-CRIN INNOVTE network, Saint-Étienne, France; Service de cardiologie et de médecine vasculaire, délégation recherche clinique et innovation, centre hospitalier intercommunal Toulon La Seyne-sur-Mer, Toulon, France
| | - O Espitia
- Service de médecine interne et vasculaire, Institut du thorax, Nantes université, CHU de Nantes, Inserm UMR 1087-CNRS UMR 6291, Team III Vascular & Pulmonary diseases, Nantes, France
| | - J Schmidt
- F-CRIN INNOVTE network, Saint-Étienne, France; Service d'urgence, CHU de Clermont-Ferrand, Lapsco-UMR UBP-CNRS 6024, université Clermont Auvergne, Clermont-Ferrand, France
| | - F Couturaud
- F-CRIN INNOVTE network, Saint-Étienne, France; Département de médecine interne, médecine vasculaire et pneumologie, CHU de Brest, Inserm U1304-GETBO, université de Brest, Brest, France
| | - I Mahé
- F-CRIN INNOVTE network, Saint-Étienne, France; Service de médecine interne, hôpital Louis-Mourier, AP-HP, Colombes, France; Université Paris Cité, Inserm UMR S1140, Innovations thérapeutiques en hémostase, Paris, France
| | - O Sanchez
- F-CRIN INNOVTE network, Saint-Étienne, France; Université Paris Cité, Inserm UMR S1140, Innovations thérapeutiques en hémostase, Paris, France; Service de pneumologie et de soins intensifs, hôpital européen Georges-Pompidou, AP-HP, Paris, France
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Bertoletti L, Girard P, Elias A, Espitia O, Schmidt J, Couturaud F, Mahé I, Sanchez O. Recurrent venous thromboembolism in anticoagulated cancer patients: Diagnosis and treatment. Arch Cardiovasc Dis 2024; 117:84-93. [PMID: 38065753 DOI: 10.1016/j.acvd.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 12/27/2023]
Abstract
Patients with cancer are at significantly increased risk of venous thromboembolism (VTE), due both to the impact of malignant disease itself and to the impact of certain anticancer drugs on haemostasis. This is true both for first episode venous thromboembolism and recurrence. The diagnosis and management of VTE recurrence in patients with cancer poses particular challenges, and these are reviewed in the present article, based on a systematic review of the relevant scientific literature published over the last decade. Furthermore, it is uncertain whether diagnostic algorithms for venous thromboembolism, validated principally in untreated non-cancer patients, are also valid in anticoagulated cancer patients: the available data suggests that clinical decision rules and D-dimer testing perform less well in this clinical setting. In patients with cancer, computed tomography pulmonary angiography and venous ultrasound appear to be the most reliable diagnostic tools for diagnosis of pulmonary embolism and deep vein thrombosis respectively. Options for treatment of venous thromboembolism include low molecular weight heparins (at a therapeutic dose or an increased dose), fondaparinux or oral direct factor Xa inhibitors. The choice of treatment should take into account the nature (pulmonary embolism or VTE) and severity of the recurrent event, the associated bleeding risk, the current anticoagulant treatment (type, dose, adherence and possible drug-drug interactions) and cancer progression.
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Affiliation(s)
- Laurent Bertoletti
- Service de médecine vasculaire et thérapeutique, CHU de Saint-Étienne, INSERM, UMR1059, Équipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, INSERM, CIC-1408, CHU Saint-Etienne, Saint-Etienne, France; F-CRIN INNOVTE network, Saint-Etienne, France.
| | - Philippe Girard
- Institut du thorax Curie-Montsouris, institut mutualiste Montsouris, Paris, France; F-CRIN INNOVTE network, Saint-Etienne, France
| | - Antoine Elias
- Service de cardiologie et de médecine vasculaire, délégation recherche clinique et innovation, centre hospitalier intercommunal Toulon La Seyne-sur-Mer, Toulon, France; F-CRIN INNOVTE network, Saint-Etienne, France
| | - Olivier Espitia
- Service de médecine interne et vasculaire, institut du thorax, Nantes université, CHU de Nantes, Inserm UMR 1087-CNRS UMR 6291, Team III Vascular & Pulmonary diseases, Nantes, France
| | - Jeannot Schmidt
- Service d'urgence, CHU de Clermont-Ferrand, LAPSCO-UMR UBP-CNRS 6024, Université Clermont Auvergne, Clermont-Ferrand, France; F-CRIN INNOVTE network, Saint-Etienne, France
| | - Francis Couturaud
- Département de médecine interne, médecine vasculaire et pneumologie, CHU de Brest, Inserm U1304-GETBO, université de Brest, Brest, France; F-CRIN INNOVTE network, Saint-Etienne, France
| | - Isabelle Mahé
- Service de médecine interne, hôpital Louis-Mourier, AP-HP, Colombes, France; Université Paris Cité, Inserm UMR S1140, innovations thérapeutiques en hémostase, Paris, France; F-CRIN INNOVTE network, Saint-Etienne, France
| | - Olivier Sanchez
- Université Paris Cité, Inserm UMR S1140, innovations thérapeutiques en hémostase, Paris, France; Service de pneumologie et de soins intensifs, Hôpital européen Georges-Pompidou, AP-HP, Paris, France; F-CRIN INNOVTE network, Saint-Etienne, France
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6
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Niu Y, Yu C, Li Z, Li Z. A case report of surgical treatment for locally advanced renal carcinoma. Asian J Surg 2023; 46:5120-5121. [PMID: 37442701 DOI: 10.1016/j.asjsur.2023.06.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/24/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Affiliation(s)
- Yuanjian Niu
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chenhui Yu
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhuoheng Li
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhipeng Li
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
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7
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Tan JE, Vishnu S, Singh D. Pulmonary tumor embolism in renal cell carcinoma detected by hybrid CT and F18-PSMA PET. Radiol Case Rep 2023; 18:4222-4225. [PMID: 37745764 PMCID: PMC10514386 DOI: 10.1016/j.radcr.2023.08.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 09/26/2023] Open
Abstract
We present the case of a 75-year-old female in which a pulmonary tumor embolism was detected incidentally on a prostate-specific membrane antigen positron emission tomography-computed tomography restaging scan. This occurred on the background of renal cell carcinoma in remission with pazopanib systemic therapy and a right nephrectomy 4 years prior. An avidity to prostate-specific membrane antigen in the superior lingula of the left upper lobe of the lung coupled with contrast-enhanced computed tomography findings found the lesion to be a tumor thrombus. This case serves to highlight the effectiveness of incorporating contrast-enhanced computed tomography with prostate-specific membrane antigen positron emission tomography and to consider the rare diagnosis of a pulmonary tumor embolism.
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Affiliation(s)
- Jared E. Tan
- The Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Sai Vishnu
- Qscan Radiology Clinics, Woolloongabba, Queensland, Australia
| | - Dalveer Singh
- Qscan Radiology Clinics, Woolloongabba, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
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8
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Gashler KR, Ritchie AK, Hood R, Ibekwe SO. Anesthetic Management of Renal Cell Carcinoma With Level 3 Inferior Vena Cava Extension in a Patient With Severe Coronary Artery Disease. Cureus 2023; 15:e44180. [PMID: 37641726 PMCID: PMC10460294 DOI: 10.7759/cureus.44180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 08/31/2023] Open
Abstract
A 49-year-old male with untreated type 2 diabetes and a family history of coronary artery disease (CAD) presented with right flank pain and profound progressive dyspnea on exertion to the emergency department of Ben Taub Hospital, a tertiary county hospital. Workup revealed right renal cell carcinoma with metastatic extension into the inferior vena cava (IVC). In addition, the patient had significant CAD with 95% occlusion of the proximal left anterior descending coronary artery amenable to percutaneous coronary intervention (PCI). After multidisciplinary discussions involving cardiovascular anesthesiology, cardiology, urology, and cardiothoracic surgery, it was estimated that the mortality benefit of immediate tumor resection outweighed the patient's need for PCI and further cardiac optimization. The patient underwent curative resection and thrombectomy under transesophageal echocardiography (TEE) guidance without complication, made an expedient recovery, and was discharged home on postoperative day seven.
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Affiliation(s)
- Kyle R Gashler
- Anesthesiology, Baylor College of Medicine, Houston, USA
| | - Alan K Ritchie
- Anesthesiology, Baylor College of Medicine, Houston, USA
| | - Ryan Hood
- Anesthesiology, Baylor College of Medicine, Houston, USA
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