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Jiang T, Mao H, Chen Q, Cao L, He Y, Gao X, Chen W, Zhang H. Trim24 prompts tumor progression via inducing EMT in renal cell carcinoma. Open Med (Wars) 2020; 15:1153-1162. [PMID: 33336072 PMCID: PMC7718642 DOI: 10.1515/med-2020-0206] [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: 12/23/2019] [Revised: 03/26/2020] [Accepted: 05/24/2020] [Indexed: 12/20/2022] Open
Abstract
Renal cell carcinoma (RCC) is a malignant tumor originating from renal tubular epithelial cells with poor prognosis and high metastatic rate. Tripartite motif-containing 24 (Trim24) is a member of the tripartite motif (Trim) family and also a valuable oncogene, but its role in RCC remains unclear. We constructed the overexpression and knockdown of Trim24 cell lines to investigate its roles in RCC progression. CCK8, wound healing, and transwell assay were performed to determine the proliferation, migration, and invasion of RCC cell lines, respectively. Moreover, the expression of Trim24 and its clinicopathological significance were evaluated in a human RCC tissue microarray. From our results, Trim24 promoted the proliferation, migration, and invasion of RCC cells in vitro. Importantly, overexpression of Trim24 led to a significant increase in the expression levels of MMP-2, MMP-9, fibronectin, snail, vimentin, N-cadherin, and β-catenin, inducing the EMT process in turn, while the expression of these proteins was significantly downregulated when Trim24 was knocked down in ACHN cells. In addition, Trim24 was significantly upregulated in RCC, and its high expression was negatively associated with the tumor size. Trim24 might operate as an oncogene in RCC progression by inducing the EMT process, suggesting that Trim24 was a potential target for human RCC.
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Affiliation(s)
- Tao Jiang
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Houping Mao
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Qin Chen
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Linsheng Cao
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Yanfeng He
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Xingjian Gao
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Wenwei Chen
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
| | - Hua Zhang
- Department of Urology, Second District, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China
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Knott ME, Minatta JN, Roulet L, Gueglio G, Pasik L, Ranuncolo SM, Nuñez M, Puricelli L, De Lorenzo MS. Circulating Fibroblast Growth Factor 21 (Fgf21) as Diagnostic and Prognostic Biomarker in Renal Cancer. ACTA ACUST UNITED AC 2016; 1. [PMID: 27358750 PMCID: PMC4922529 DOI: 10.4172/2155-9929.s2-015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background The finding of new biomarkers is needed to have a better sub-classification of primary renal tumors (RCC) as well as more reliable predictors of outcome and therapy response. In this study, we evaluated the role of circulating FGF21, an endocrine factor, as a diagnostic and prognostic biomarker for ccRCC. Materials and Methods Serum samples from healthy controls (HC), clear cell and chromophobe RCC cancer patients were obtained from the serum biobank “Biobanco Público de Muestras Séricas Oncológicas” (BPMSO) of the “Instituto de Oncología “Ángel H. Roffo”. Serum FGF21 and leptin were measured by ELISA while other metabolic markers were measured following routinely clinical procedures. Results One of our major findings was that FGF21 levels were significantly increased in ccRCC patients compared with HC. Moreover, we showed an association between the increased serum FGF21 levels and the shorter disease free survival in a cohort of 98 ccRCC patients, after adjustment for other predictors of outcome. Conclusion Our results suggest that higher FGF21 serum level is an independent prognostic biomarker, associated with worse free-disease survival.
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Affiliation(s)
- M E Knott
- Instituto de Oncología "Ángel H Roffo", Universidad de Buenos Aires (UBA), Argentina
| | - J N Minatta
- Hospital Italiano de Buenos Aires- Buenos Aires, Argentina
| | - L Roulet
- Hospital Italiano de Buenos Aires- Buenos Aires, Argentina
| | - G Gueglio
- Hospital Italiano de Buenos Aires- Buenos Aires, Argentina
| | - L Pasik
- Instituto de Oncología "Ángel H Roffo", Universidad de Buenos Aires (UBA), Argentina
| | - S M Ranuncolo
- Instituto de Oncología "Ángel H Roffo", Universidad de Buenos Aires (UBA), Argentina
| | - M Nuñez
- Facultad de Farmacia y Bioquímica UBA, Argentina
| | - L Puricelli
- Instituto de Oncología "Ángel H Roffo", Universidad de Buenos Aires (UBA), Argentina
| | - M S De Lorenzo
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, State University of New Jersey, USA
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Yadlapalli SB, Shi D, Vaishampayan U. Renal Cell Carcinoma: Clinical Presentation, Staging, and Prognostic Factors. KIDNEY CANCER 2015. [DOI: 10.1007/978-3-319-17903-2_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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4
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Kurosch M, Reiter M, Haferkamp A. Epidemiologie, Diagnostik und chirurgische Therapie des Nierenzellkarzinoms. DER ONKOLOGE 2014. [DOI: 10.1007/s00761-014-2750-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yanlan C, Liping S, Shaomin C, Zi L. Metastasis to the parotid region as an initial presentation of renal cell carcinoma: A case report. Oncol Lett 2013; 5:997-999. [PMID: 23426388 PMCID: PMC3576383 DOI: 10.3892/ol.2013.1110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 12/10/2012] [Indexed: 11/25/2022] Open
Abstract
Distant metastasis of renal cell carcinoma (RCC) to the parotid region is extremely rare, particularly as an initial presentation. In the present study, we report a rare case of parotid region metastasis from RCC as an initial presentation in a 44-year-old female who presented with a painless lump in the right parotid region. Investigation revealed RCC in the left renal region and metastasis to the right iliac area. A radical nephrectomy was performed but the patient refused any further treatment. After seven months, the patient reappeared with systemic multiple metastases, with the exception of previous metastases that were enlarging significantly. On admission, interleukin-2 and local radiotherapy were administered. However, oral mucositis occurred. Targeted therapy with sunitinib was recommended.
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Affiliation(s)
- Chai Yanlan
- Cancer Center, First Hospital of Xi'an Jiaotong University, Shaan'xi, Xi'an 710061, P.R. China
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6
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Renal Cell Carcinoma: Clinical Presentation, Staging, and Prognostic Factors. KIDNEY CANCER 2012. [DOI: 10.1007/978-3-642-21858-3_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Feifer A, Savage C, Rayala H, Lowrance W, Gotto G, Sprenkle P, Gupta A, Taylor J, Bernstein M, Adeniran A, Tickoo SK, Reuter VE, Russo P. Prognostic impact of muscular venous branch invasion in localized renal cell carcinoma cases. J Urol 2010; 185:37-42. [PMID: 21074196 DOI: 10.1016/j.juro.2010.08.084] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Indexed: 01/12/2023]
Abstract
PURPOSE Beginning with the 2002 American Joint Committee on Cancer staging system, renal sinus muscular venous branch invasion has prognostic equivalence with renal vein invasion in renal cell carcinoma cases. To validate this presumed equivalence we compared patients with isolated muscular venous branch invasion to those with renal vein invasion and those with no confirmed vascular invasion. MATERIALS AND METHODS From routine cataloging at our institution we identified 500 patients who underwent partial or radical nephrectomy from 2003 to 2008. After excluding patients with metastasis or noncortical renal cell carcinoma pathology we identified 85 with positive muscular venous branch invasion (+). The 259 patients with pT1-2 muscular venous branch (-) invasion and the 71 with renal vein (+) invasion served as comparison groups. We used a multivariate Cox model to control for tumor characteristics using the Kattan renal cell carcinoma nomogram. RESULTS On multivariate analysis the risk of recurrence in the pT1-2 muscular venous branch invasion (-) group was lower than in the muscular venous branch invasion (+) group (HR 0.06, 95% CI 0.02-0.18, p < 0.001). Patients with renal vein invasion (+) had a recurrence rate similar to that in those with muscular venous branch invasion (+) (HR 0.80, 95% CI 0.39-1.65, p = 0.6). The overall survival rate was higher in the muscular venous branch invasion (-) group than in the other groups. CONCLUSIONS Patients with muscular venous branch invasion have an outcome inferior to that in patients with pT1-2 disease. This confirms the adverse prognosis of muscular venous branch invasion and supports pathological up-staging. The prognosis of muscular venous branch invasion is similar to that of renal vein invasion, although we cannot exclude the possibility of a difference. Our findings underscore the importance of close patient followup and careful pathological assessment of the nephrectomy specimen.
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Affiliation(s)
- Andrew Feifer
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
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Affiliation(s)
- A Haferkamp
- Klinik fur Urologie, Universitatsklinikum Im Neuenheimer Feld 110, 69120 Heidelberg.
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Süer E, Ergün G, Baltacı S, Bedük Y. Does Renal Capsular Invasion Have Any Prognostic Value in Localized Renal Cell Carcinoma? J Urol 2008; 180:68-71. [DOI: 10.1016/j.juro.2008.03.060] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Evren Süer
- Department of Urology, Faculty of Medicine, University of Ankara and Department of Statistics, Faculty of Science, University of Hacettepe (GE), Ankara, Turkey
| | - Gül Ergün
- Department of Urology, Faculty of Medicine, University of Ankara and Department of Statistics, Faculty of Science, University of Hacettepe (GE), Ankara, Turkey
| | - Sümer Baltacı
- Department of Urology, Faculty of Medicine, University of Ankara and Department of Statistics, Faculty of Science, University of Hacettepe (GE), Ankara, Turkey
| | - Yaşar Bedük
- Department of Urology, Faculty of Medicine, University of Ankara and Department of Statistics, Faculty of Science, University of Hacettepe (GE), Ankara, Turkey
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Rodríguez Jasso V, Serrano Brambila E, Maldonado Alcaraz E. [Prognostic factors in localised and regionally advanced renal cell carcinoma]. Actas Urol Esp 2008; 32:320-4. [PMID: 18512389 DOI: 10.1016/s0210-4806(08)73837-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In the last 10 years, several factors have been identified to confer a prognostic effect on renal cancer outcome. Pathologic stage, nuclear and histologic grade are the most frecuent studied and the most important at this moment. We evaluated those factors and introduced some others, looking for new parameters that could be useful. 96 cases of non methastatic renal cell cancer were included in our study. We found that as was mentioned by other authors pathologic and Furhman stage are the stronger prognostic factors but the presence of palpable tumor, pain and weight lost had significance too.
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Pedrosa I, Chou MT, Ngo L, H Baroni R, Genega EM, Galaburda L, DeWolf WC, Rofsky NM. MR classification of renal masses with pathologic correlation. Eur Radiol 2007; 18:365-75. [PMID: 17899106 DOI: 10.1007/s00330-007-0757-0] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Revised: 07/28/2007] [Accepted: 08/24/2007] [Indexed: 02/06/2023]
Abstract
To perform a feature analysis of malignant renal tumors evaluated with magnetic resonance (MR) imaging and to investigate the correlation between MR imaging features and histopathological findings. MR examinations in 79 malignant renal masses were retrospectively evaluated, and a feature analysis was performed. Each renal mass was assigned to one of eight categories from a proposed MRI classification system. The sensitivity and specificity of the MRI classification system to predict the histologic subtype and nuclear grade was calculated. Subvoxel fat on chemical shift imaging correlated to clear cell type (p < 0.05); sensitivity = 42%, specificity = 100%. Large size, intratumoral necrosis, retroperitoneal vascular collaterals, and renal vein thrombosis predicted high-grade clear cell type (p < 0.05). Small size, peripheral location, low intratumoral SI on T2-weighted images, and low-level enhancement were associated with low-grade papillary carcinomas (p < 0.05). The sensitivity and specificity of the MRI classification system for diagnosing low grade clear cell, high-grade clear cell, all clear cell, all papillary, and transitional carcinomas were 50% and 94%, 93% and 75%, 92% and 83%, 80% and 94%, and 100% and 99%, respectively. The MRI feature analysis and proposed classification system help predict the histological type and nuclear grade of renal masses.
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Affiliation(s)
- Ivan Pedrosa
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02118, USA.
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Dall'Oglio MF, Arap MA, Antunes AA, Cury J, Leite KR, Srougi M. Impact of Clinicopathological Parameters in Patients Treated for Renal Cell Carcinoma. J Urol 2007; 177:1687-91. [PMID: 17437783 DOI: 10.1016/j.juro.2007.01.065] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE We determined the impact of clinical and pathological factors in the outcome of patients with renal cell carcinoma treated surgically. MATERIALS AND METHODS We retrospectively reviewed the records of 230 consecutive patients after radical or partial nephrectomy. We analyzed clinical (incidental or symptomatic disease) and pathological (tumor size, histological type, Fuhrman nuclear grade, microvascular invasion and lymph node involvement) parameters. Disease-free and cancer specific survival curves were individualized for each parameter and on multivariate analysis. RESULTS Median postoperative followup was 34.3 months, median time to recurrence was 22 months and mean overall survival was 130 months. A total of 40 patients (17.3%) presented with local and/or metastatic recurrence and 32 (13.9%) died of the disease. Five-year disease-free and cancer specific survival rates on univariate analysis were 56.7% and 64% for symptomatic tumors, 76.6% and 68% for clear cell carcinoma, 26.9% and 39% for sarcomatoid tumors, 34.7% and 47.5% for high grade tumors, 26.7% and 39.7% for microvascular invasion, 37.5% and 49.1% for tumors larger than 7 cm, and 11% and 32% for lymph node involvement, respectively. On univariate analysis patients with lymph node involvement and microvascular invasion had a poor prognosis. Multivariate analysis showed that the single independent prognostic factor was microvascular invasion. CONCLUSIONS This study points out different clinical and pathological prognostic factors of survival in patients treated for renal cell carcinoma. Microvascular invasion was the only independent prognostic factor on multivariate analysis.
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Affiliation(s)
- Marcos F Dall'Oglio
- Division of Urology, University of São Paulo Medical School, São Paulo, Brazil.
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Leppert JT, Pantuck AJ, Figlin RA, Belldegrun AS. The role of molecular markers in the staging of renal cell carcinoma. BJU Int 2007; 99:1208-11. [PMID: 17441912 DOI: 10.1111/j.1464-410x.2007.06812.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- John T Leppert
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1738, USA
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Kanofsky JA, Phillips CK, Stifelman MD, Taneja SS. Impact of discordant radiologic and pathologic tumor size on renal cancer staging. Urology 2006; 68:728-31. [PMID: 17070342 DOI: 10.1016/j.urology.2006.04.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Revised: 03/25/2006] [Accepted: 04/25/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To determine whether the discrepancy in the radiologic and pathologic size of renal cell carcinoma influences the final cancer stage. METHODS Renal masses resected from December 1999 to September 2004 were identified using a pathologic database and compared by surgical accession number to an existing clinical renal tumor database to identify those T1 and T2 tumors for which radiologic and pathologic data were available. The tumor histologic features, maximal pathologic diameter, and maximal radiologic diameter were recorded. The percentage of tumor size reduction was then calculated using these data. RESULTS Of the 236 renal cancers evaluated, 52% had regressed in size when comparing the pathologic and radiologic sizes. When stratified by histologic subtype, clear cell tumors regressed more often and to a greater degree than those that were chromophobe or papillary. Also, 15 organ-confined tumors were downstaged when comparing the maximal radiologic diameter and the maximal pathologic diameter, and 13 of these were clear cell tumors. CONCLUSIONS A reduction in kidney tumor size is commonly observed at surgical resection because of a loss of blood flow to the tumor. This tumor size reduction has an impact on the final pathologic stage in organ-confined tumors for which size is the only criterion. The greatest tumor size reduction, and most frequent downstaging, was observed for conventional (clear cell) tumors. We believe this may explain, in part, the worse stage-stratified outcomes for clear cell tumors compared with other tumor types. We propose that renal cancer staging should be determined from accurate measurement of the radiologic size, rather than the pathologic size.
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Affiliation(s)
- Jamie A Kanofsky
- Department of Urology, Urologic Oncology Program, New York University School of Medicine, New York, New York 10016, USA
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Majhail NS, Wood L, Elson P, Finke J, Olencki T, Bukowski RM. Adjuvant subcutaneous interleukin-2 in patients with resected renal cell carcinoma: a pilot study. Clin Genitourin Cancer 2006; 5:50-6. [PMID: 16859579 DOI: 10.3816/cgc.2006.n.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A pilot study was conducted to investigate the toxicity and tolerance to low-dose subcutaneous interleukin-2 (IL-2) for patients with resected renal cell carcinoma (RCC) at high risk for recurrent disease (TNM stages III and IV resected distant metastases). PATIENTS AND METHODS Patients with surgically resected locally advanced (T3-4 or N1-2) or metastatic RCC were randomly assigned to 1 of 4 treatment groups that received different dose levels and schedules of subcutaneous IL-2 as follows: dose level 1, 4 MIU/m2 per day, every other week for 24 weeks (n = 10); dose level 2, 8 MIU/m2 per day, every other week for 24 weeks (n = 9); dose level 3, 4 MIU/m2 per day, weeks 1-4, 9-12, and 17-20 (n = 11); and dose level 4, 8 MIU/m2 per day, weeks 1-4, 9-12, and 17-20 (n = 10). Interleukin-2 was administered in 2 daily doses on days 1-5 of each week indicated. A dose level was considered tolerable if no more than 2 patients experienced grade 3/4 toxicity. RESULTS Forty-one patients were entered in the study and 40 were evaluable for toxicity. Therapy was well tolerated at all dose levels and schedules, with most patients (98%) experiencing mild-to-moderate constitutional symptoms. Grade 3/4 toxicity was seen in 8 patients (20%). Interleukin-2 dose reductions were required in 7 patients, and no patient discontinued therapy secondary to toxicity. Of 39 patients evaluable for efficacy, 31 have experienced relapse (79%), and 15 have died (38%). Median survival was 1.4 years, and the 3-year disease-free survival rate was 33%. Median overall survival has not been reached; however, the 3-year survival rate was 70%. There was no statistically significant difference between any of the treatment arms with respect to disease-free survival or 3-year survival (P > 0.54 and P >or= 0.09 for all pairwise comparisons), schedules (dose level 1/2 vs. 3/4; P = 0.46 and P = 0.5), or dose of IL-2 administered (dose level 1/3 vs. 2/4; P = 0.99 and P = 0.1). CONCLUSION Subcutaneous IL-2 was well tolerated for 6 months in patients with surgically resected RCC at high risk of recurrence. Future adjuvant trials in this setting are not likely to include IL-2 in view of the clinical efficacy and favorable toxicity profiles of selected multitargeted kinase inhibitors.
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Affiliation(s)
- Navneet S Majhail
- Oncology and Transplantation, University of Minnesota, Minneapolis, USA
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Rouvière O, Bouvier R, Négrier S, Badet L, Lyonnet D. Nonmetastatic renal-cell carcinoma: is it really possible to define rational guidelines for post-treatment follow-up? ACTA ACUST UNITED AC 2006; 3:200-13. [PMID: 16596144 DOI: 10.1038/ncponc0479] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2005] [Accepted: 02/16/2006] [Indexed: 11/09/2022]
Abstract
Defining rational follow-up guidelines in patients treated for cancer is important, from both a medical and an economical perspective. Renal-cell carcinoma is reputed to be unpredictable in its course and only a few, and often contradictory, follow-up guidelines exist for patients treated for nonmetastatic renal-cell carcinoma. Recent advances in tumor biology have contributed to a better understanding of this cancer and have indicated that personalized follow-up regimens, based on tumor and host molecular characteristics, might be possible in the near future.
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Affiliation(s)
- Olivier Rouvière
- Department of Urinary, Vascular and Interventional Radiology, Edouard Herriot Hospital, Lyon, France.
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Ficarra V, Martignoni G, Lohse C, Novara G, Pea M, Cavalleri S, Artibani W. External validation of the Mayo Clinic Stage, Size, Grade and Necrosis (SSIGN) score to predict cancer specific survival using a European series of conventional renal cell carcinoma. J Urol 2006; 175:1235-9. [PMID: 16515968 DOI: 10.1016/s0022-5347(05)00684-1] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Indexed: 11/29/2022]
Abstract
PURPOSE We validated the Mayo Clinic SSIGN score in an independent European sample of patients who were surgically treated for conventional RCC. MATERIALS AND METHODS In our kidney cancer database we identified 388 patients who were treated with radical or partial nephrectomy for conventional RCC between 1986 and 2000. Associations of the pathological features studied with death from RCC were evaluated using the log rank test and Cox proportional hazards regression model. The predictive ability of competing models was evaluated using the c index. RESULTS Median followup in the 290 patients who were alive at last followup was 5 years (range 5 months to 17 years). The estimated cancer specific survival rate 5 years following surgery was 81.3%. All features that comprise the SSIGN score except tumor size were significantly associated with death from RCC in a multivariate setting, resulting in a c index of 0.90. The median SSIGN score in the 388 patients studied was 3 (range 0 to 15). The c index in a model containing the clear cell SSIGN score was 0.88. Five-year cancer specific survival rates in patients with a score of 0 to 2, 3 to 4, 5 to 6, 7 to 9 and 10 or more were 100.0%, 90.5%, 63.6%, 46.8% and 0%, respectively. CONCLUSIONS We provide the first external validation of the Mayo Clinic SSIGN score for conventional RCC. This simple algorithm resulted in a high degree of prognostic accuracy.
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Law CL, Gordon KA, Toki BE, Yamane AK, Hering MA, Cerveny CG, Petroziello JM, Ryan MC, Smith L, Simon R, Sauter G, Oflazoglu E, Doronina SO, Meyer DL, Francisco JA, Carter P, Senter PD, Copland JA, Wood CG, Wahl AF. Lymphocyte activation antigen CD70 expressed by renal cell carcinoma is a potential therapeutic target for anti-CD70 antibody-drug conjugates. Cancer Res 2006; 66:2328-37. [PMID: 16489038 DOI: 10.1158/0008-5472.can-05-2883] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Metastatic renal cell carcinoma (RCC) is an aggressive disease refractory to most existing therapeutic modalities. Identifying new markers for disease progression and drug targets for RCC will benefit this unmet medical need. We report a subset of clear cell and papillary cell RCC aberrantly expressing the lymphocyte activation marker CD70, a member of the tumor necrosis factor superfamily. Importantly, CD70 expression was found to be maintained at the metastatic sites of RCC. Anti-CD70 antibody-drug conjugates (ADC) consisting of auristatin phenylalanine phenylenediamine (AFP) or monomethyl auristatin phenylalanine (MMAF), two novel derivatives of the anti-tubulin agent auristatin, mediated potent antigen-dependent cytotoxicity in CD70-expressing RCC cells. Cytotoxic activity of these anti-CD70 ADCs was associated with their internalization and subcellular trafficking through the endosomal-lysosomal pathway, disruption of cellular microtubule network, and G2-M phase cell cycle arrest. The efficiency of drug delivery using anti-CD70 as vehicle was illustrated by the much enhanced cytotoxicity of antibody-conjugated MMAF compared with free MMAF. Hence, ADCs targeted to CD70 can selectively recognize RCC, internalize, and reach the appropriate subcellular compartment(s) for drug release and tumor cell killing. In vitro cytotoxicity of these ADCs was confirmed in xenograft models using RCC cell lines. Our findings provide evidence that CD70 is an attractive target for antibody-based therapeutics against metastatic RCC and suggest that anti-CD70 ADCs can provide a new treatment approach for advanced RCC patients who currently have no chemotherapeutic options.
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Affiliation(s)
- Che-Leung Law
- Seattle Genetics, Inc., Bothell, Washington 98021, USA.
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Giménez Bachs JM, Donate Moreno MJ, Salinas Sánchez AS, Lorenzo Romero JG, Segura Martín M, Hernández Millán IR, Pastor Navarro H, Martínez Córcoles B, Cañamares Pabolaza L, Virseda Rodríguez JA. Incidencia creciente en el carcinoma de células renales. Actas Urol Esp 2006; 30:295-300. [PMID: 16749586 DOI: 10.1016/s0210-4806(06)73442-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To analyze the change in the behavior of renal cell carcinoma for its presentation, treatment, histology and mortality during a 17 year period. MATERIAL AND METHOD Retrospective study on 212 patients diagnosed with renal cell carcinoma in our Department from the year 1988 up to 2004, analyzing the clinical and demographic data and comparing them to each other according to two periods: 1988-1996 and 1997-2004. RESULTS An increase has been appreciated in the incidence of renal tumors in the second period and in a same way an increase in the incidental diagnosis and in the practice of nephron sparing surgery. Clear cell type was the most frequent in both periods and tumoral size was higher in the first period than in second. TNM stage I was the most frequent, although in first period it was higher percentage of stage IV. Cause-specific mortality has increased in the last years. CONCLUSION An increase is appreciated in the incidence of renal cell tumors. Although the diagnosis is in earlier stages, a descent in the mortality has not been found.
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Affiliation(s)
- J M Giménez Bachs
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete.
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Lohse CM, Cheville JC. A Review of Prognostic Pathologic Features and Algorithms for Patients Treated Surgically for Renal Cell Carcinoma. Clin Lab Med 2005; 25:433-64. [PMID: 15848745 DOI: 10.1016/j.cll.2005.01.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Accurate subtyping of RCC is critically important and should be considered in algorithms that are developed as prognostic tools for the patient and clinician. The TNM classification, already a powerful prognostic factor, will continue to evolve. The authors recommend that each component of the classification be assessed and reported during pathologic examination. This article also highlighted the importance of assigning a nuclear grade that is based on standardized and reproducible criteria that reflect the heterogeneity of nuclear and nucleolar features within RCC. Lastly, it is increasingly evident that coagulative tumor necrosis and sarcomatoid differentiation are compelling prognostic factors, on par with nuclear grade, and should be assessed routinely. To conclude, the complete list of pathologic features that are evaluated as part of the Mayo Clinic Nephrectomy Registry is presented. The features that are reported routinely in clinical practice also are indicated; this can serve as a guide for the reporting of results from the pathologic examination of RCC.
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Ficarra V, Novara G, Galfano A, Artibani W. Neoplasm Staging and Organ-Confined Renal Cell Carcinoma: A Systematic Review. Eur Urol 2004; 46:559-64. [PMID: 15474263 DOI: 10.1016/j.eururo.2004.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Several TNM staging system editions were published over the years for renal cell carcinoma (RCC). Using a search strategy similar to the one used by the TNM process Subcommittee for "literature watch", we searched MEDLINE with the intent to critically analyze literature concerning the different TNM editions and the data regarding the optimal breakpoints to substratify localized RCC. MATERIAL AND METHODS The electronic search was conducted as follows: "Neoplasm staging" [MeSH] AND "Carcinoma, Renal Cell" [MeSH]. At the end of a process of abstract analysis performed separately by three of the authors, 34 papers were included in the systematic review. RESULTS All the 34 selected papers were retrospective studies. According to the 1987 version of TNM classification, no paper showed statistically significant cancer-specific survival probability differences between stage I and stage II RCC. According to the 1997 TNM version, the results were controversial. While a few papers found significantly different cancer-specific survival rates between stage I and stage II RCC, several others failed to do so. With the aim to stratify patients with localized RCC, most of the papers proposed an ideal breakpoint ranging from 4.5 to 5.5 cm. CONCLUSION This literature review highlighted that a correct definition of the staging of organ-confined RCC was far from being achieved and provided an appropriate synopsis of the available data for further update of the TNM staging system.
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Affiliation(s)
- Vincenzo Ficarra
- Cattedra e Divisione Clinicizzata di Urologia, Università di Verona, Ospedale Policlinico, Piazzale Ludovico Scuro, 37134 Verona, Italy.
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Ficarra V, Novara G, Galfano A, Novella G, Schiavone D, Artibani W. Application of TNM, 2002 version, in localized renal cell carcinoma: is it able to predict different cancer-specific survival probability? Urology 2004; 63:1050-4. [PMID: 15183948 DOI: 10.1016/j.urology.2004.01.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2003] [Accepted: 01/14/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To verify whether the latest version of the TNM staging system (2002) could predict different cancer-specific survival in patients with localized renal cell carcinoma (RCC; Stage T1-T2N0M0). METHODS According to the 2002 TNM staging system, we reassigned the pathologic stage of 702 patients who had undergone surgical treatment for RCC from 1976 to 2000. We selected 491 patients with localized RCC (pT1-T2N0M0). In 334 patients (68.0%), we had performed radical nephrectomy; in 121 (24.6%), elective nephron-sparing surgery; and in 36 (7.3%), imperative nephron-sparing surgery. Cancer-specific survival was estimated according to the Kaplan-Meier method. The log-rank test and Cox's proportional hazard model was used for univariate and multivariate analysis, respectively. RESULTS Of the 491 tumors, 249 (50.7%) were classified as pT1a, 155 (31.6%) as pT1b, and 87 (17.7%) as pT2. The median follow-up was 75 months. The 5-year and 10-year cancer-specific survival probabilities were, respectively, 97.4% and 95.6% in the pT1a patients, 92.5% and 89.8% in the pT1b patients, and 89.3% and 78.5% in the pT2 patients. The survival curve comparison was statistically significant both between pT1a and pT1b (log-rank test, P = 0.01) and between pT1a and pT2 (log-rank test, P = 0.0007). No statistically significant difference was observed between the pT1b and pT2-specific survival probabilities (log-rank test, P = 0.42). CONCLUSIONS The 2002 TNM staging system does not seem able to predict different cancer-specific survival between pT1b and pT2 RCC. These data highlight the need to define an optimal breakpoint to stratify patients with localized RCC.
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Abstract
After diagnosis of a suspicious renal mass on ultrasound or CT, renal MR imaging typically is ordered to characterize the mass further, stage the mass, or resolve discordant ultrasound and CT results. MR imaging may also be ordered in cases in which ultrasound is poor or in instances in which contrast-enhanced CT may be ill advised.
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Affiliation(s)
- Vincent B Ho
- Department of Radiology and Radiological Sciences, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA.
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Ficarra V, Martignoni G, Maffei N, Brunelli M, Novara G, Zanolla L, Pea M, Artibani W. Original and reviewed nuclear grading according to the Fuhrman system. Cancer 2004; 103:68-75. [PMID: 15573369 DOI: 10.1002/cncr.20749] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The objective of the current study was to evaluate the reproducibility of the Fuhrman nuclear grading system as well as its independent predictive value in a series of patients with conventional renal cell carcinoma (RCC). METHODS The authors selected 388 patients who had undergone surgical treatment for conventional RCC between 1986 and 2000. Pathology slides from the selected patients were reviewed by a single pathologist, who reassigned a Fuhrman nuclear grade and assessed the presence of tumor necrosis. The pathologist was blinded to both the original pathologic diagnosis and follow-up data. The kappa statistic was used to evaluate concordance between original and reviewed nuclear grades. The log-rank test was used for univariate analyses, and a Cox proportional hazards model was used for multivariate analyses. RESULTS The original Fuhrman nuclear grade was Grade 1 (G1) in 111 patients (28.6%), G2 in 141 patients (36.3%), G3 in 108 patients (27.8%), and G4 in 28 patients (7.3%). After pathology slide review, nuclear grades were reassigned as follows: G1 in 49 patients (12.6%), G2 in 138 patients (35.6%), G3 in 150 patients (38.7%), and G4 in 51 patients (13.1%). The grade of concordance was moderate (kappa=0.44; P <0.001). Univariate analyses identified three separate prognostic categories defined by nuclear grade (G1 and G2 vs. G3 vs. G4). Both the original and the reviewed Fuhrman nuclear grading systems were capable of independently predicting disease-specific survival in patients with conventional RCC. CONCLUSIONS The interobserver reproducibility of Fuhrman nuclear grading was moderate. The substantial overlap in survival curves for G1 and G2 tumors provided an opportunity to cluster those categories, and the resulting three-tiered nuclear grading system was an independent predictor of cause-specific survival in patients with conventional RCC. Other independent predictors of survival included pathologic stage and tumor necrosis status.
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