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Erdem S, Bertolo R, Campi R, Capitanio U, Amparore D, Anceschi U, Mir MC, Roussel E, Pavan N, Carbonara U, Kara O, Klatte T, Marchioni M, Pecoraro A, Muselaers S, Marandino L, Diana P, Borregales L, Palumbo C, Warren H, Wu Z, Calio A, Ciccarese C, Degirmenci E, Aydin R, Rebez G, Schips L, Simone G, Minervini A, Serni S, Ozcan F. The prognostic role of histomorphological subtyping in nonmetastatic papillary renal cell carcinoma after curative surgery: is subtype really irrelevant? A propensity score matching analysis of a multi-institutional real life data. Urol Oncol 2024; 42:163.e1-163.e13. [PMID: 38443238 DOI: 10.1016/j.urolonc.2024.01.028] [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: 09/02/2023] [Revised: 12/10/2023] [Accepted: 01/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND AND AIM The role of histomorphological subtyping is an issue of debate in papillary renal cell carcinoma (papRCC). This multi-institutional study investigated the prognostic role of histomorphological subtyping in patients undergoing curative surgery for nonmetastatic papRCC. PATIENTS AND METHODS A total of 1,086 patients undergoing curative surgery were included from a retrospectively collected multi-institutional nonmetastatic papRCC database. The patients were divided into 2 groups based on histomorphological subtyping (type 1, n = 669 and type 2, n = 417). Furthermore, a propensity score-matching (PSM) cohort in 1:1 ratio (n = 317 for each subtype) was created to reduce the effect of potential confounding variables. The primary outcome of the study, the predictive role of histomorphological subtyping on the prognosis (recurrence free survival [RFS], cancer specific survival [CSS] and overall survival [OS]) in nonmetastatic papRCC after curative surgery, was investigated in both overall and PSM cohorts. RESULTS In overall cohort, type 2 group were older (66 vs. 63 years, P = 0.015) and more frequently underwent radical nephrectomy (37.4% vs. 25.6%, P < 0.001) and lymphadenectomy (22.3% vs. 15.1%, P = 0.003). Tumor size (4.5 vs. 3.8 cm, P < 0.001) was greater, and nuclear grade (P < 0.001), pT stage (P < 0.001), pN stage (P < 0.001), VENUSS score (P < 0.001) and VENUSS high risk (P < 0.001) were significantly higher in type 2 group. 5-year RFS (89.6% vs. 74.2%, P < 0.001), CSS (93.9% vs. 84.2%, P < 0.001) and OS (88.5% vs. 78.5%, P < 0.001) were significantly lower in type 2 group. On multivariable analyses, type 2 was a significant predictor for RFS (HR:1.86 [95%CI:1.33-2.61], P < 0.001) and CSS (HR:1.91 [95%CI:1.20-3.04], P = 0.006), but not for OS (HR:1.27 [95%CI:0.92-1.76], P = 0.150). In PSM cohort balanced with age, gender, symptoms at diagnosis, pT and pN stages, tumor grade, surgical margin status, sarcomatoid features, rhabdoid features, and presence of necrosis, type 2 increased recurrence risk (HR:1.75 [95%CI: 1.16-2.65]; P = 0.008), but not cancer specific mortality (HR: 1.57 [95%CI: 0.91-2.68]; P = 0.102) and overall mortality (HR: 1.01 [95%CI: 0.68-1.48]; P = 0.981) CONCLUSIONS: This multiinstitutional study suggested that type 2 was associated with adverse histopathologic outcomes, and predictor of RFS and CSS after surgical treatment of nonmetastatic papRCC, in overall cohort. In propensity score-matching cohort, type 2 remained the predictor of RFS. Eventhough 5th WHO classification for renal tumors eliminated histomorphological subtyping, these findings suggest that subtyping is relevant from the point of prognostic view.
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Affiliation(s)
- Selcuk Erdem
- Division of Urologic Oncology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey; European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands.
| | - Riccardo Bertolo
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, San Carlo Di Nancy Hospital, Rome, Italy
| | - Riccardo Campi
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, Department of Experimental and Clinical Medicine University of Florence, Florence, Italy
| | - Umberto Capitanio
- Department of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniele Amparore
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Umberto Anceschi
- Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Eduard Roussel
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Nicola Pavan
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Umberto Carbonara
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Unit of Andrology and Kidney Transplantation, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy
| | - Onder Kara
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Tobias Klatte
- Department of Urology, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - Michele Marchioni
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Angela Pecoraro
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Urology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Stijn Muselaers
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Laura Marandino
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pietro Diana
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy
| | - Leonardo Borregales
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Carlotta Palumbo
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Hannah Warren
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Surgery and Interventional Science, University College London, London, UK
| | - Zhenjie Wu
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Anna Calio
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Chiara Ciccarese
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Enes Degirmenci
- Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Resat Aydin
- Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Rebez
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Luigi Schips
- Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Giuseppe Simone
- School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Andrea Minervini
- Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Florence, Italy
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, Department of Experimental and Clinical Medicine University of Florence, Florence, Italy
| | - Faruk Ozcan
- Division of Urologic Oncology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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Chrabańska M, Rynkiewicz M, Kiczmer P, Drozdzowska B. Immunohistochemical Expression of CD44, MMP-2, MMP-9, and Ki-67 as the Prognostic Markers in Non-Clear Cell Renal Cell Carcinomas-A Prospective Cohort Study. J Clin Med 2022; 11:jcm11175196. [PMID: 36079127 PMCID: PMC9457518 DOI: 10.3390/jcm11175196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
CD44 is the most frequently reported marker of the cancer stem cells in renal cell carcinoma (RCC). Matrix metalloproteinases MMP-2 and MMP-9 are key regulators of tumor invasion and metastasis. The aim of this study was to investigate the clinicopathologic and prognostic values of the immunohistochemical expression of CD44, MMP2, MMP9, and Ki-67 in papillary and chromophobe RCCs. In the case of papillary RCC, MMP-2 expression was positively correlated with patient age (p < 0.05), while CD44 expression was positively correlated with tumor stage (τ = 0.26, p < 0.05). Moreover, CD44 expression positively correlated with MMP-9 (τ = 0.39, p < 0.05). In the case of chromophobe RCC, only Ki-67 expression was negatively correlated with tumor stage (τ = −0.44, p < 0.05). During follow-up, a death was documented in 6 patients with papillary RCC. In these patients, CD44 expression was not a significant factor affecting the overall survival of patients (p > 0.05), whereas there was a positive correlation between increased MMP-9 expression and shorter overall survival (p < 0.05). Taken together, carcinogenesis in papillary RCC is probably dependent on both cancer stem cells and metalloproteinases activity. Expression of CD44 and MMP-9 can significantly improve the prediction of papillary RCC prognosis in the future.
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Papillary renal cell carcinoma: a single institutional study of 199 cases addressing classification, clinicopathologic and molecular features, and treatment outcome. Mod Pathol 2022; 35:825-835. [PMID: 34949764 PMCID: PMC9177523 DOI: 10.1038/s41379-021-00990-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 01/20/2023]
Abstract
The morphologic spectrum of type 1 papillary renal cell carcinoma (PRCC) is not well-defined, since a significant proportion of cases have mixed type 1 and 2 histology. We analyzed 199 cases of PRCC with any (even if focal) type 1 features, with a median follow-up of 12 years, to identify clinicopathological features associated with outcome. Ninety-five tumors (48%) of the cohort contained some type 2 component (median amount: 25%; IQR: 10%, 70%). As a group they showed high rates of progression-free (PFS) and cancer-specific survival (CSS). Tumor size, mitotic rate, lymphovascular invasion, sarcomatoid differentiation, sheet-like architecture, and lack of tumor circumscription were significantly associated with CSS (p ≤ 0.015) on univariate analysis. While predominant WHO/ISUP nucleolar grade was associated with PFS (p = 0.013) and CSS (p = 0.030), the presence of non-predominant (<50%) nucleolar grade did not show association with outcome (p = 0.7). PFS and CSS showed no significant association with the presence or the amount of type 2 morphology. We compared the molecular alterations in paired type 1 and type 2 areas in a subset of 22 cases with mixed type 1 and 2 features and identified 12 recurrently mutated genes including TERT, ARID1A, KDM6A, KMT2D, NFE2L2, MET, APC, and TP53. Among 78 detected somatic mutations, 61 (78%) were shared between the paired type 1 and type 2 areas. Copy number alterations, including chromosome 7 and 17 gains, were similar between type 1 and 2 areas. These findings support that type 2 features in a PRCC with mixed histology represent either morphologic variance or clonal evolution. Our study underscores the notion that PRCC with any classic type 1 regions is best considered as type 1 PRCC and assigned the appropriate WHO/ISUP nucleolar grade. It provides additional evidence that type 2 PRCC as a separate category should be re-assessed and likely needs to be abandoned.
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Xiong S, Zhu W, Li X, Yu Y, Yang K, Zhang L, Mi Y, Li X, Zhou L. Whether histologic subtyping affect the oncological outcomes of patients with papillary renal cell carcinoma: evidence from a systematic review and meta-analysis. Transl Androl Urol 2021; 10:3255-3266. [PMID: 34532250 PMCID: PMC8421816 DOI: 10.21037/tau-21-329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/29/2021] [Indexed: 01/03/2023] Open
Abstract
Background Whether the histologic subtype (type 1 and type 2) of papillary renal cell carcinoma (pRCC) is a tool to predict the prognosis is of great debate. This study is aimed to evaluate the prognostic significance of histologic subtype in patients with pRCC after surgery through a systematic review and meta-analysis. Methods We searched PubMed, the Web of Science, Cochrane library and EMBASE databases to identify studies published until January 20, 2021 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were deemed eligible if they compared the overall survival (OS), cancer specific survival (CSS), recurrence-free survival (RFS) or disease-free survival (DFS) between patients with type 1 or type 2 pRCC. And the corresponding hazard ratios (HRs) and 95% conference intervals (CIs) were collected for meta-analysis and further subgroup analysis. Results Overall 22 studies with a total of 4,494 patients were considered eligible and included for the systematic review and meta-analysis. The pooled results showed that type 2 pRCC was associated with a worse OS (pooled HR 1.61, 95% CI: 1.10–2.36, P=0.02) and CSS (pooled HR 1.59, 95% CI: 1.00–2.51, P=0.05). However, the subgroup analysis yielded the same result as the initial analysis only when the HRs were extracted from univariate analysis. In studies with multivariate analysis, type 2 pRCC was not statistically associated with a worse OS (pooled HR 1.22, 95% CI: 0.97–1.53, P=0.27), CSS (pooled HR 1.16, 95% CI: 0.67–2.00, P=0.60), and DFS (pooled HR 1.33, 95% CI: 0.93–1.91, P=0.12) compared to type 1 pRCC. Discussion Histologic subtype is not an independent prognostic factor for patients with pRCC, although the result needs to be taken with caution. And studies with retrospective study design, larger sample size and longer follow-up period are required to verify these results.
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Affiliation(s)
- Shengwei Xiong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Weijie Zhu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Xinfei Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Yanfei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Lei Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Yue Mi
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
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Jang NR, Baek J, Ko Y, Song PH, Gu MJ. High MCM6 Expression as a Potential Prognostic Marker in Clear-cell Renal Cell Carcinoma. In Vivo 2021; 35:299-306. [PMID: 33402477 DOI: 10.21873/invivo.12259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 12/11/2022]
Abstract
AIM Minichromosome maintenance (MCM) proteins are involved in initiation of DNA replication and cell-cycle progression. Loss of MCM function results in genomic instability and causes carcinogenesis. Among MCM genes, the role and prognostic value of MCM6 expression in clear-cell renal cell carcinoma (ccRCC) has not been elucidated. MATERIALS AND METHODS We assessed the mRNA expression level of MCM6 using the Gene Expression Profiling Interactive Analysis database and investigated MCM6 protein expression by immunohistochemistry in 238 ccRCC cases. RESULTS High MCM6 expression was significantly associated with increasing tumor size, pT, stage, tumor necrosis, and metastasis. Furthermore, high MCM6 expression was significantly associated with shorter overall and disease-free survival, and was an independent unfavorable prognostic marker. Regarding patients with metastasis, high MCM6-expressing ccRCC conferred significantly shorter survival than for those with low expression. CONCLUSION A high MCM6 expression level may be a promising biomarker to predict tumor progression, metastasis, and survival in patients with ccRCC.
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Affiliation(s)
- Nu-Ri Jang
- Department of Pathology, Yeungnam University College of Medicine, Gyeongsan, Republic of Korea
| | - Jina Baek
- Department of Pathology, Yeungnam University College of Medicine, Gyeongsan, Republic of Korea
| | - Younghwii Ko
- Department of Urology, Yeungnam University College of Medicine, Gyeongsan, Republic of Korea
| | - Phil Hyun Song
- Department of Urology, Yeungnam University College of Medicine, Gyeongsan, Republic of Korea
| | - Mi-Jin Gu
- Department of Pathology, Yeungnam University College of Medicine, Gyeongsan, Republic of Korea;
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Wang JP, Liu L, Li ZA, Wang Q, Wang XY, Lin J. Ki-67 labelling index is related to the risk classification and prognosis of gastrointestinal stromal tumours: a retrospective study. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:103-114. [PMID: 32718848 DOI: 10.1016/j.gastrohep.2020.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/08/2020] [Accepted: 05/18/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the digestive tract with malignant potential. The current risk classification standard is unable to accurately evaluate the invasiveness and clinical outcomes of GISTs. Ki-67 labelling index (LI) may be an effective indicator in assessing tumour invasiveness and prognosis, however, its exact value in GISTs is still uncertain. The aims of our study were to evaluate the correlation of the Ki-67 LI and clinicopathological features of GISTs and to assess the potential value of the Ki-67 LI in GISTs classification and prognosis. METHODS The clinical, pathological and prognostic data were collected and analysed to identify the independent influential factors of GISTs risk stratification and the predictors of GISTs prognosis. RESULTS The Ki-67 LI was significantly associated with the clinicopathological features of tumour progression (P<0.05). It was an independent influential factor of GISTs risk classification (odds ratio: 1.322; 95% confidence interval: 1.031-1.696) (P=0.028), and the area under the curve (AUC) value of the Ki-67 LI on the discrimination ability of GISTs risk stratification was 0.906 (P<0.001). The optimal cutoff value of the Ki-67 LI was 6% (sensitivity of 87.5% and specificity of 76.2%), and patients with Ki-67 LI≥6% exhibited significantly poorer progression-free survival (PFS) than those with Ki-67 LI<6% (P<0.001). The AUC value of the Ki-67 LI for predicting PFS in postoperative patients was 0.813 (P=0.03). CONCLUSIONS The Ki-67 LI has appreciated value to predict the risk grade and prognosis of GISTs. Patients with Ki-67 LI≥6% are prone to recurrence and metastasis after operation and may need a close follow-up.
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Affiliation(s)
- Jian-Ping Wang
- Department of Intensive Care Unit, Chengdu Third People's Hospital, Chengdu, China
| | - Lan Liu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseasesv, Wuhan, China
| | - Zi-Ang Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseasesv, Wuhan, China
| | - Qian Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseasesv, Wuhan, China
| | - Xiao-Yue Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseasesv, Wuhan, China
| | - Jun Lin
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseasesv, Wuhan, China.
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Zhang T, Pabla S, Lenzo FL, Conroy JM, Nesline MK, Glenn ST, Papanicolau-Sengos A, Burgher B, Giamo V, Andreas J, Wang Y, Bshara W, Madden KG, Shirai K, Dragnev K, Tafe LJ, Gupta R, Zhu J, Labriola M, McCall S, George DJ, Ghatalia P, Dayyani F, Edwards R, Park MS, Singh R, Jacob R, George S, Xu B, Zibelman M, Kurzrock R, Morrison C. Proliferative potential and response to nivolumab in clear cell renal cell carcinoma patients. Oncoimmunology 2020; 9:1773200. [PMID: 32923131 PMCID: PMC7458647 DOI: 10.1080/2162402x.2020.1773200] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Biomarkers predicting immunotherapy response in metastatic renal cell cancer (mRCC) are lacking. PD-L1 immunohistochemistry is a complementary diagnostic for immune checkpoint inhibitors (ICIs) in mRCC, but has shown minimal clinical utility and is not used in routine clinical practice. Methods Tumor specimens from 56 patients with mRCC who received nivolumab were evaluated for PD-L1, cell proliferation (targeted RNA-seq), and outcome. Results For 56 patients treated with nivolumab as a standard of care, there were 2 complete responses and 8 partial responses for a response rate of 17.9%. Dividing cell proliferation into tertiles, derived from the mean expression of 10 proliferation-associated genes in a reference set of tumors, poorly proliferative tumors (62.5%) were more common than moderately (30.4%) or highly proliferative (8.9%) counterparts. Moderately proliferative tumors were enriched for PD-L1 positive (41.2%), compared to poorly proliferative counterparts (11.4%). Objective response for moderately proliferative (29.4%) tumors was higher than that of poorly (11.4%) proliferative counterparts, but not statistically significant (p = .11). When cell proliferation and negative PD-L1 tumor proportion scores were combined statistically significant results were achieved (p = .048), showing that patients with poorly proliferative and PD-L1 negative tumors have a very low response rate (6.5%) compared to moderately proliferative PD-L1 negative tumors (30%). Conclusions Cell proliferation has value in predicting response to nivolumab in clear cell mRCC patients, especially when combined with PD-L1 expression. Further studies which include the addition of progression-free survival (PFS) along with sufficiently powered subgroups are required to further support these findings.
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Affiliation(s)
- Tian Zhang
- Department of Medicine, Duke University, Durham, NC, USA
| | | | | | - Jeffrey M Conroy
- R&D, OmniSeq, Inc, Buffalo, NY, USA.,Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | - Sean T Glenn
- R&D, OmniSeq, Inc, Buffalo, NY, USA.,Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | | | | | | | | | | | - Katherine G Madden
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Keisuke Shirai
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Konstantin Dragnev
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Laura J Tafe
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Rajan Gupta
- Department of Medicine, Duke University, Durham, NC, USA
| | - Jason Zhu
- Department of Medicine, Duke University, Durham, NC, USA
| | | | - Shannon McCall
- Department of Medicine, Duke University, Durham, NC, USA
| | | | - Pooja Ghatalia
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, US
| | - Farshid Dayyani
- Department of Medicine, University of California, Irvine, CA, USA
| | - Robert Edwards
- Department of Medicine, University of California, Irvine, CA, USA
| | - Michelle S Park
- Department of Medicine, University of California, Irvine, CA, USA
| | - Rajbir Singh
- Department of Medicine, Meharry Medical College, Nashville, TN, US
| | - Robin Jacob
- Department of Medicine, Meharry Medical College, Nashville, TN, US
| | - Saby George
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bo Xu
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Zibelman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, US
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, Moores Cancer Center, La Jolla, CA, USA
| | - Carl Morrison
- R&D, OmniSeq, Inc, Buffalo, NY, USA.,Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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C-Met as a Key Factor Responsible for Sustaining Undifferentiated Phenotype and Therapy Resistance in Renal Carcinomas. Cells 2019; 8:cells8030272. [PMID: 30909397 PMCID: PMC6468372 DOI: 10.3390/cells8030272] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 01/08/2023] Open
Abstract
C-Met tyrosine kinase receptor plays an important role under normal and pathological conditions. In tumor cells’ overexpression or incorrect activation of c-Met, this leads to stimulation of proliferation, survival and increase of motile activity. This receptor is also described as a marker of cancer initiating cells. The latest research shows that the c-Met receptor has an influence on the development of resistance to targeted cancer treatment. High c-Met expression and activation in renal cell carcinomas is associated with the progression of the disease and poor survival of patients. C-Met receptor has become a therapeutic target in kidney cancer. However, the therapies used so far using c-Met tyrosine kinase inhibitors demonstrate resistance to treatment. On the other hand, the c-Met pathway may act as an alternative target pathway in tumors that are resistant to other therapies. Combination treatment together with c-Met inhibitor reduces tumor growth, vascularization and pro-metastatic behavior and results in suppressed mesenchymal phenotype and vascular endothelial growth factor (VEGF) secretion. Recently, it has been shown that the acquirement of mesenchymal phenotype or lack of cell differentiation might be related to the presence of the c-Met receptor and is consequently responsible for therapy resistance. This review presents the results from recent studies identifying c-Met as an important factor in renal carcinomas being responsible for tumor growth, progression and metastasis, indicating the role of c-Met in resistance to antitumor therapy and demonstrating the pivotal role of c-Met in supporting mesenchymal cell phenotype.
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Cheng J, Mo X, Wang X, Parwani A, Feng Q, Huang K. Identification of topological features in renal tumor microenvironment associated with patient survival. Bioinformatics 2019; 34:1024-1030. [PMID: 29136101 PMCID: PMC7263397 DOI: 10.1093/bioinformatics/btx723] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 11/07/2017] [Indexed: 11/13/2022] Open
Abstract
Motivation As a highly heterogeneous disease, the progression of tumor is not only achieved by unlimited growth of the tumor cells, but also supported, stimulated, and nurtured by the microenvironment around it. However, traditional qualitative and/or semi-quantitative parameters obtained by pathologist’s visual examination have very limited capability to capture this interaction between tumor and its microenvironment. With the advent of digital pathology, computerized image analysis may provide a better tumor characterization and give new insights into this problem. Results We propose a novel bioimage informatics pipeline for automatically characterizing the topological organization of different cell patterns in the tumor microenvironment. We apply this pipeline to the only publicly available large histopathology image dataset for a cohort of 190 patients with papillary renal cell carcinoma obtained from The Cancer Genome Atlas project. Experimental results show that the proposed topological features can successfully stratify early- and middle-stage patients with distinct survival, and show superior performance to traditional clinical features and cellular morphological and intensity features. The proposed features not only provide new insights into the topological organizations of cancers, but also can be integrated with genomic data in future studies to develop new integrative biomarkers. Availability and implementation https://github.com/chengjun583/KIRP-topological-features Supplementary information Supplementary data are available atBioinformatics online.
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Affiliation(s)
- Jun Cheng
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Xiaokui Mo
- Center for Biostatistics, The Ohio State University Wexner Medical Center
| | - Xusheng Wang
- Department of Electrical and Computer Engineering
| | | | - Qianjin Feng
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Kun Huang
- Department of Electrical and Computer Engineering.,Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA.,Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Integrated Phenotypic/Genotypic Analysis of Papillary Renal Cell Carcinoma Subtypes: Identification of Prognostic Markers, Cancer-related Pathways, and Implications for Therapy. Eur Urol Focus 2018; 4:740-748. [DOI: 10.1016/j.euf.2016.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 08/11/2016] [Accepted: 09/07/2016] [Indexed: 12/13/2022]
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Wang Z, Xie H, Guo L, Cai Q, Shang Z, Jiang N, Niu Y. Prognostic and clinicopathological value of Ki-67/MIB-1 expression in renal cell carcinoma: a meta-analysis based on 4579 individuals. Cancer Manag Res 2017; 9:679-689. [PMID: 29200888 PMCID: PMC5701556 DOI: 10.2147/cmar.s141670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Previous studies have investigated the prognostic significance of Ki-67/MIB-1 expression in renal cell carcinoma (RCC), however, the reports are controversial and inconsistent. This study aimed to investigate Ki-67/MIB-1 expression in RCC and its correlation with prognosis and clinicopathological features. Methods We searched relevant studies that reported associations between Ki-67/MIB-1 expression and prognosis in RCC from PubMed, Embase, Web of Science, and Cochrane Library studies published until April 14, 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted from eligible studies. Fixed and random effects models were used to calculate pooled HRs and 95% CIs according to heterogeneity. Results A total of 4579 participants from 23 eligible studies were included in this analysis. The results showed that Ki-67/MIB-1 expression was associated with poor overall survival (HR=2.06, 95% CI: 1.64-2.57) and cancer specific survival (HR=2.01, 95% CI: 1.66-2.44). In addition, Ki-67/MIB-1 expression was also correlated with TNM stage (III/IV vs I/II: OR=1.92, 95% CI: 1.61-2.28), pathological T stage (pT3/pT4 vs pT1/pT2: OR=1.56, 95% CI: 1.21-2.02), distant metastasis (M1 vs M0: OR=1.81, 95% CI: 1.34-2.43), and Fuhrman grade (III/IV vs I/II: OR=1.94, 95% CI: 1.21-3.10). Conclusion Our study demonstrates that the presence of high Ki-67/MIB-1 expression and advanced clinicopathological features were correlated with poor prognosis in RCC patients.
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Affiliation(s)
- Zhun Wang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Hui Xie
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Linpei Guo
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiliang Cai
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhiqun Shang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ning Jiang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yuanjie Niu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
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Cool DW, Kachura JR. Radiofrequency Ablation of T1a Renal Cell Carcinomas within Renal Transplant Allografts: Oncologic Outcomes and Graft Viability. J Vasc Interv Radiol 2017; 28:1658-1663. [PMID: 28916346 DOI: 10.1016/j.jvir.2017.07.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/17/2017] [Accepted: 07/23/2017] [Indexed: 02/09/2023] Open
Abstract
PURPOSE To evaluate oncologic outcomes and graft viability after percutaneous radiofrequency (RF) ablation of renal cell carcinoma (RCC) developing within renal transplant allografts. MATERIALS AND METHODS A single-institution, retrospective study reviewed all patients treated with RF ablation for RCC between February 2004 and May 2016. Ten patients were identified (age 49.6 y ± 12.6; 9 men, 1 woman) with 12 biopsy-confirmed RCC tumors within the allograft (all T1a, mean diameter 2.0 cm ± 0.7). Mean time from transplant to RCC diagnosis was 13.2 years ± 6.3. RF ablation was performed on an outpatient basis using conscious sedation. Procedural efficacy, complications, oncologic outcomes, and allograft function were evaluated. Statistical analysis with t tests and Pearson correlation compared allograft function before and after RF ablation and impact of proportional ablation size to allograft volume on function after ablation. RESULTS Technical success rate and primary technique efficacy were 100% (12/12). No local or distant RCC progression was seen at mean follow-up of 54.3 months ± 38.7 (range, 9-136 months). Graft failure requiring hemodialysis or repeat transplantation occurred in 3 patients (26, 354, and 750 d after RF ablation), all of whom had glomerular filtration rate (GFR) < 30 mL/min/1.73 m2 before ablation. For all patients, mean GFR 6 months after RF ablation (35.8 mL/min/1.73 m2 ± 17.7) was not significantly different (P = .8) from preprocedure GFR (36.2 mL/min/1.73 m2 ± 14.3). Proportional volume of allograft that was ablated did not correlate with immediate or long-term GFR changes. One patient died of unrelated comorbidities 52 months after ablation. No major complications occurred. CONCLUSIONS RF ablation of renal allograft RCC provided effective oncologic control without adverse impact on graft viability.
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Affiliation(s)
- Derek W Cool
- Division of Vascular and Interventional Radiology, Department of Medical Imaging, University of Toronto, University Health Network, 200 Elizabeth St., Toronto, M5G 2C4, Canada.
| | - John R Kachura
- Division of Vascular and Interventional Radiology, Department of Medical Imaging, University of Toronto, University Health Network, 200 Elizabeth St., Toronto, M5G 2C4, Canada
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Choueiri TK, Plimack E, Arkenau HT, Jonasch E, Heng DY, Powles T, Frigault MM, Clark EA, Handzel AA, Gardner H, Morgan S, Albiges L, Pal SK. Biomarker-Based Phase II Trial of Savolitinib in Patients With Advanced Papillary Renal Cell Cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.72.2967] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Patients with advanced papillary renal cell carcinoma (PRCC) have limited therapeutic options. PRCC may involve activation of the MET pathway, for example, through gene amplification or mutations. Savolitinib (AZD6094, HMPL-504, volitinib) is a highly selective MET tyrosine kinase inhibitor. We report results of a single-arm, multicenter, phase II study evaluating the safety and efficacy of savolitinib in patients with PRCC according to MET status. Patients and Methods Patients with histologically confirmed locally advanced or metastatic PRCC were enrolled and received savolitinib 600 mg orally once daily. MET-driven PRCC was defined as any of the following: chromosome 7 copy gain, focal MET or HGF gene amplification, or MET kinase domain mutations. Efficacy was assessed according to MET status. Safety, toxicity, and patient-reported health-related quality-of-life outcomes were assessed in all patients. Results Of 109 patients treated, PRCC was MET driven in 44 (40%) and MET independent in 46 (42%); MET status was unknown in 19 (17%). MET-driven PRCC was strongly associated with response; there were eight confirmed partial responders with MET-driven disease (18%), but none with MET-independent disease ( P = .002). Median progression-free survival for patients with MET-driven and MET-independent PRCC was 6.2 months (95% CI, 4.1 to 7.0 months) and 1.4 months (95% CI, 1.4 to 2.7 months), respectively (hazard ratio, 0.33; 95% CI, 0.20 to 0.52; log-rank P < .001). The most frequent adverse events associated with savolitinib were nausea, fatigue, vomiting, and peripheral edema. Conclusion These data show activity and tolerability of savolitinib in the subgroup of patients with MET-driven PRCC. Furthermore, molecular characterization of MET status was more predictive of response to savolitinib than a classification based on pathology. These findings justify investigating savolitinib in MET-driven PRCC.
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Affiliation(s)
- Toni K. Choueiri
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Elizabeth Plimack
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Hendrik-Tobias Arkenau
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Eric Jonasch
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Daniel Y.C. Heng
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Thomas Powles
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Melanie M. Frigault
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Edwin A. Clark
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Amir A. Handzel
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Humphrey Gardner
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Shethah Morgan
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Laurence Albiges
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
| | - Sumanta Kumar Pal
- Toni K. Choueiri, Dana-Farber Cancer Institute, Boston; Melanie M. Frigault, Edwin A. Clark, Amir A. Handzel, and Humphrey Gardner, AstraZeneca, Waltham, MA; Elizabeth Plimack, Fox Chase Cancer Center, Philadelphia, PA; Eric Jonasch, MD Anderson Cancer Center, Houston, TX; Sumanta Kumar Pal, City of Hope, Duarte, CA; Hendrik-Tobias Arkenau, Sarah Cannon Research Institute, University College London Cancer Institute; Thomas Powles, Barts Cancer Institute, London; Shethah Morgan, AstraZeneca, Cambridge,
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Kim JH, Kim BJ, Kim HS. Clinicopathological impacts of high c-Met expression in renal cell carcinoma: a meta-analysis and review. Oncotarget 2017; 8:75478-75487. [PMID: 29088883 PMCID: PMC5650438 DOI: 10.18632/oncotarget.20796] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/21/2017] [Indexed: 12/15/2022] Open
Abstract
c-Met overexpression has been observed in renal cell carcinoma (RCC). However, its clinicopathological impacts remain uncertain. We performed this meta-analysis to evaluate the pathologic and prognostic impacts of high c-Met expression in patients with RCC. A systematic computerized search of the electronic databases PubMed and Embase was performed. From 12 studies, 1,724 patients with RCC were included in the meta-analysis. Compared with RCCs showing low c-Met expression, tumors with high c-Met expression showed significantly higher nuclear grade (odds ratio = 2.45 [95% CI: 1.43-4.19], P = 0.001) and pT stage (odds ratio = 2.18 [95% CI: 1.27-3.72], P = 0.005). In addition, patients with c-Met-high RCC showed significantly worse overall survival than those with c-Met-low tumor (hazard ratio = 1.32 [95% CI: 1.12-1.56], P = 0.0009). In conclusion, this meta-analysis demonstrates that high c-Met expression correlate with significantly worse pathological features and overall survival, indicating c-Met overexpression is a potential adverse prognostic marker for patients with RCC.
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Affiliation(s)
- Jung Han Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Bum Jun Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea.,Department of Internal Medicine, National Army Capital Hospital, The Armed Forces Medical Command, Sungnam 13574, Republic of Korea
| | - Hyeong Su Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
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Chen S, Zhu Y, Cui J, Wang Y, Xia Y, Song J, Cheng S, Zhou C, Zhang D, Zhang B, Shi B. The role of c-Met in prognosis and clinicopathology of renal cell carcinoma: Results from a single-centre study and systematic review. Urol Oncol 2017; 35:532.e15-532.e23. [PMID: 28427859 DOI: 10.1016/j.urolonc.2017.03.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 03/12/2017] [Accepted: 03/21/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVES The c-Met proto-oncogene pathway plays an important role in the progression of various cancers. However, the effect of the c-Met pathway on renal cell carcinoma (RCC) remains controversial. We decided to clarify the role of c-Met in prognosis and clinicopathology of RCC. METHODS A total of 10 pairs of tumour and adjacent tissues were obtained from patients with primary RCC between 2013 and 2014 and tissue microarrays to assess c-Met expression in tumour tissues from 90 patients with RCC by Western blot and immunohistochemical staining. We also presented a meta-analysis to explore the correlation between c-Met and pathological grade and stage of RCC. The two-tailed Pearson's χ2 and Fischer exact tests were used to compare categorical variables. Multivariate analysis was performed using the multivariate Cox proportional hazards model. RESULTS C-Met protein levels were increased in 8 of 10 RCC tissue samples compared with their adjacent normal tissue and c-Met expression levels were positively associated with a high nuclear grade (P = 0.008) and pT stage (P = 0.002). Multivariate analysis showed that a high expression of c-Met was an independent predictor of disease-specific survival (P = 0.017). A meta-analysis found that increased c-Met expression in RCC tissues was closely correlated with high tumour grade (P<0.001) and high pT stage (P = 0.001). Most importantly, c-Met expression was significantly correlated with disease-specific survival (P<0.001). CONCLUSIONS Because c-Met is strongly associated with pathological grade, stage and disease-specific survival, c-Met levels may have potential to predict patient prognosis and to guide clinical diagnosis and treatment.
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Affiliation(s)
- Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Yaofeng Zhu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Jianfeng Cui
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Yong Wang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Yangyang Xia
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Jing Song
- Laboratory of Experimental Teratology, Ministry of Education and Institute of Experimental Nuclear Medicine, School of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Shanshan Cheng
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Changkuo Zhou
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Dongqing Zhang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Bing Zhang
- Department of Urology, Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.
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Xie Y, Chen L, Ma X, Li H, Gu L, Gao Y, Fan Y, Zhang Y, Zhang X. Prognostic and clinicopathological role of high Ki-67 expression in patients with renal cell carcinoma: a systematic review and meta-analysis. Sci Rep 2017; 7:44281. [PMID: 28287186 PMCID: PMC5347162 DOI: 10.1038/srep44281] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/06/2017] [Indexed: 01/08/2023] Open
Abstract
Previous studies have elevated the prognostic value of Ki-67 in renal cell carcinoma (RCC), but the reports are controversial and inconsistent. We conducted a systematic review and meta-analysis to clarify the significance of Ki-67 in RCC prognosis. We systematically searched PubMed, Web of Science, and Embase to identify relevant studies until April 2016. Based on the inclusion and exclusion criteria, 20 studies, including 5,398 patients, were eligible for further analysis. Results showed that high Ki-67 expression in RCC was associated with poor OS (HR = 1.95, 95% CI: 1.44–2.64), CSS (HR = 1.67, 95% CI: 1.47–1.89), and DFS (HR = 2.56, 95% CI: 1.79–3.67). In addition, high Ki-67 expression was significantly associated with TNM stage (III/IV vs. I/II: RR = 2.03, 95% CI: 1.68–2.44), pathological T stage (T3/T4 vs. T1/T2: RR = 1.67, 95% CI: 1.35–2.06), metastasis (yes vs. no: RR = 2.15, 95% CI: 1.77–2.62), and Fuhrman grade (III/IV vs. I/II: RR = 1.77, 95% CI: 1.20–2.60). Our study suggested that Ki-67 was a prognostic marker in RCC. High Ki-67 expression was correlated with poor prognosis and advanced clinicopathological features, and it could serve as a biomarker for disease management.
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Affiliation(s)
- Yongpeng Xie
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China.,Medical School, Nankai University, Tianjin, People's Republic of China
| | - Luyao Chen
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xin Ma
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hongzhao Li
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Liangyou Gu
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yu Gao
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yang Fan
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yu Zhang
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xu Zhang
- State Key Laboratory of Kidney Diseases, Department of Urology, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, People's Republic of China
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Papillary renal cell carcinoma: correlation of tumor grade and histologic characteristics with clinical outcome. Hum Pathol 2015; 46:1411-7. [DOI: 10.1016/j.humpath.2015.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/22/2015] [Accepted: 07/01/2015] [Indexed: 01/20/2023]
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Karthikeyan VS, Dorairajan LN, Kumar S, Vijayakumar AR, Ramesh A, Ganesh Rajesh N, Halanaik D, Gupta S. Sporadic bilateral synchronous multicentric papillary renal cell carcinoma masquerading as bilateral multifocal pyelonephritis. Ann R Coll Surg Engl 2014; 96:e7-10. [PMID: 24992402 DOI: 10.1308/003588414x13814021679113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pyelonephritis is defined as an inflammation of the kidney and renal pelvis. The diagnosis is usually clinical. Acute multifocal bacterial nephritis is a rare form of pyelonephritis that is more severe and sepsis is more common. We report a patient who presented with fever and right-sided abdominal pain associated with right flank tenderness, suggesting right acute pyelonephritis. Bilateral multifocal pyelonephritis was diagnosed on ultrasonography, radionuclide renal scintigraphy and computed tomography. However, owing to non-resolution of symptoms, a biopsy was performed, which showed bilateral papillary renal cell carcinoma (PRCC). PRCC is known to exhibit multicentricity. To our knowledge, a case of bilateral multicentric PRCC masquerading as bilateral multifocal pyelonephritis has not been reported in the English literature. This case highlights the need to be vigilant while treating patients with focal lesions of the kidney as an inflammatory condition lest a malignancy should be missed.
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Affiliation(s)
- V S Karthikeyan
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Abstract
Renal cell carcinoma (RCC) is most commonly diagnosed as an incidental finding on cross-sectional imaging and represents a significant clinical challenge. Although most patients have a surgically curable lesion at the time of diagnosis, the variability in the biologic behavior of the different histologic subtypes and tumor grade of RCC, together with the increasing array of management options, creates uncertainty for the optimal clinical approach to individual patients. State-of-the-art magnetic resonance imaging (MRI) provides a comprehensive assessment of renal lesions that includes multiple forms of tissue contrast as well as functional parameters, which in turn provides information that helps to address this dilemma. In this article, we review this evolving and increasingly comprehensive role of MRI in the detection, characterization, perioperative evaluation, and assessment of the treatment response of renal neoplasms. We emphasize the ability of the imaging "phenotype" of renal masses on MRI to help predict the histologic subtype, grade, and clinical behavior of RCC.
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Affiliation(s)
- Naomi Campbell
- Department of Radiology, Center for Biomedical Imaging, NYU Langone Medical Center, New York, NY
| | - Andrew B. Rosenkrantz
- Department of Radiology, Center for Biomedical Imaging, NYU Langone Medical Center, New York, NY
| | - Ivan Pedrosa
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX
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Abstract
Papillary renal cell cancer (RCC) constitutes approximately 10 % of renal cancers and is the commonest form after clear cell RCC, which accounts for approximately 75 % of cases. Until recently, most clinical trials in RCC were open to patients of all histologic types. Very recent clinical trials have been performed predominately in patients with clear cell RCC and relatively few trials have been done for patients with papillary RCC. The clinical characteristics of papillary RCC are less well appreciated because of both its relative rarity in the general oncology population and the lack of related clinical studies. This article reviews papillary RCC as a clinical entity separate from clear cell RCC. The MET signaling pathway, its association with increased invasion and progression of human cancer, and its dysregulation in papillary RCC is discussed. Lastly, foretinib, a multitargeted receptor tyrosine kinase inhibitor of several receptors, including MET and vascular endothelial growth factor receptor 2, is described in preclinical and phase I studies as well as in a phase II study in papillary RCC patients.
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Rosenkrantz AB, Sekhar A, Genega EM, Melamed J, Babb JS, Patel AD, Lo A, Najarian RM, Ahmed M, Pedrosa I. Prognostic implications of the magnetic resonance imaging appearance in papillary renal cell carcinoma. Eur Radiol 2012; 23:579-87. [PMID: 22903703 DOI: 10.1007/s00330-012-2631-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 06/26/2012] [Accepted: 07/08/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the prognostic implications of the MRI appearance and pathological features of papillary renal cell carcinoma (pRCC). METHODS A total of 128 pRCC in 115 patients who underwent preoperative MRI were characterised in terms of pathological type (type 1 vs. type 2), MRI appearance (focal vs. infiltrative) and additional MRI features. Patients were classified on the basis of the presence or absence of metastatic disease. RESULTS There were 65 focal type 1, 54 focal type 2 and 9 infiltrative pRCC. All infiltrative pRCC were of histopathological type 2. Renal vein thrombus was present in 89 % of infiltrative pRCC and no cases of focal pRCC. Metastatic disease was observed in 3.7 % of focal type 1, 7.5 % of focal type 2 and 75.0 % of infiltrative type 2 pRCC. Infiltrative MRI appearance was a significant predictor of metastatic disease, independent of pathological type, size and T stage (P ≤ 0.020). Among focal pRCC on MRI, pathological type 2 was not a significant predictor of metastatic disease (P = 0.648). No combination of features achieved significantly greater accuracy for predicting metastatic disease than renal vein thrombus alone (P > 0.5). CONCLUSION Infiltrative MRI appearance and renal vein thrombus identify a subset of pathological type 2 pRCC at a significantly increased risk of metastatic disease.
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Affiliation(s)
- Andrew B Rosenkrantz
- Department of Radiology, NYU Langone Medical Center, 560 First Avenue TCH-HW202, New York, NY 10016, USA.
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23
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Jonasch E, Futreal A, Davis I, Bailey S, Kim WY, Brugarolas J, Giaccia A, Kurban G, Pause A, Frydman J, Zurita A, Rini BI, Sharma P, Atkins M, Walker C, Rathmell WK. State of the science: an update on renal cell carcinoma. Mol Cancer Res 2012; 10:859-80. [PMID: 22638109 PMCID: PMC3399969 DOI: 10.1158/1541-7786.mcr-12-0117] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Renal cell carcinomas (RCC) are emerging as a complex set of diseases that are having a major socioeconomic impact and showing a continued rise in incidence throughout the world. As the field of urologic oncology faces these trends, several major genomic and mechanistic discoveries are altering our core understanding of this multitude of cancers, including several new rare subtypes of renal cancers. In this review, these new findings are examined and placed in the context of the well-established association of clear cell RCC (ccRCC) with mutations in the von Hippel-Lindau (VHL) gene and resultant aberrant hypoxia inducible factor (HIF) signaling. The impact of novel ccRCC-associated genetic lesions on chromatin remodeling and epigenetic regulation is explored. The effects of VHL mutation on primary ciliary function, extracellular matrix homeostasis, and tumor metabolism are discussed. Studies of VHL proteostasis, with the goal of harnessing the proteostatic machinery to refunctionalize mutant VHL, are reviewed. Translational efforts using molecular tools to elucidate discriminating features of ccRCC tumors and develop improved prognostic and predictive algorithms are presented, and new therapeutics arising from the earliest molecular discoveries in ccRCC are summarized. By creating an integrated review of the key genomic and molecular biological disease characteristics of ccRCC and placing these data in the context of the evolving therapeutic landscape, we intend to facilitate interaction among basic, translational, and clinical researchers involved in the treatment of this devastating disease, and accelerate progress toward its ultimate eradication.
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Affiliation(s)
| | | | - Ian Davis
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Sean Bailey
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - William Y. Kim
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | | | | | | | | | - Brian I. Rini
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
| | - Pam Sharma
- University of Texas-Houston Medical Center, Houston, TX
| | | | - Cheryl Walker
- University of Texas-Houston Medical Center, Houston, TX
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Microvessel density is high in clear-cell renal cell carcinomas of Ukrainian patients exposed to chronic persistent low-dose ionizing radiation after the Chernobyl accident. Virchows Arch 2012; 460:611-9. [PMID: 22581103 DOI: 10.1007/s00428-012-1243-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 03/26/2012] [Accepted: 04/26/2012] [Indexed: 12/27/2022]
Abstract
During the 25-year period subsequent to the Chernobyl accident, the morbidity of malignant renal tumors in Ukraine has increased from 4.7 to 10.7 per 100,000 of the total population. Recent studies of our group have shown that increases in morbidity, aggressiveness, and proliferative activity of renal cell carcinomas (RCCs), especially clear-cell renal cell carcinoma (CCRCC), in Ukrainian patients continuously inhabiting the radio-contaminated areas could be explained by specific molecular changes influenced by the so-called "chronic persistent low-dose ionizing radiation" (CPLDIR) exposure. This study aimed to examine the role of angiogenesis in CCRCC carcinogenesis associated with CPLDIR in patients living more than 20 years in cesium 137 ((137)Cs) contaminated areas after the Chernobyl accident in Ukraine. Paraffin-embedded specimens of 106 CCRCs were studied: Control cases were 18 tumors from Spanish patients (group 1), 25 tumors from Ukrainian patients from so-called clean areas without known radio-contamination (group 2), and 63 tumors from Ukrainian patients from radio-contaminated areas (group 3). For intratumoral microvessel density (MVD) determination, anti-CD31 antibody was used. A computerized image analysis program was used to quantitatively calculate the vascular density. Seventy-three percent of group 3 and 72 % of group 2 CCRCCs displayed the highest MVD. A striking increase in MVD was seen in group 3 CCRCCs, in comparison with groups 1 and 2 (p < 0.001). The majority of the hot spot vessels in group 3 was poorly differentiated. Moreover, MVD values for total vessels as well as for capillaries and tumor grade were strongly correlated. When we compared only tumor-node-metastasis tumor stages I and II, the differences remained statistically significant (p < 0.1). The ratio of the average total vessels and capillaries in the Ukrainian groups combined was 1.65:1 in comparison to the Spanish group. Our results provide evidence that CPLDIR exposure increases MVD (particularly capillary) in CCRCCs and is associated with a higher histological grade.
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Zucchi A, Novara G, Costantini E, Antonelli A, Carini M, Carmignani G, Cosciani Cunico S, Fontana D, Longo N, Martignoni G, Minervini A, Mirone V, Porena M, Roscigno M, Schiavina R, Simeone C, Simonato A, Siracusano S, Terrone C, Ficarra V. Prognostic factors in a large multi-institutional series of papillary renal cell carcinoma. BJU Int 2011; 109:1140-6. [DOI: 10.1111/j.1464-410x.2011.10517.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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26
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Lee JH, Choi JW, Kim YS. The Value of Histologic Subtyping on Outcomes of Clear Cell and Papillary Renal Cell Carcinomas: A Meta-analysis. Urology 2010; 76:889-94. [DOI: 10.1016/j.urology.2010.01.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 01/11/2010] [Accepted: 01/18/2010] [Indexed: 01/20/2023]
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27
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Klatte T, Remzi M, Zigeuner RE, Mannweiler S, Said JW, Kabbinavar FF, Haitel A, Waldert M, de Martino M, Marberger M, Belldegrun AS, Pantuck AJ. Development and External Validation of a Nomogram Predicting Disease Specific Survival After Nephrectomy for Papillary Renal Cell Carcinoma. J Urol 2010; 184:53-8. [DOI: 10.1016/j.juro.2010.03.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Indexed: 01/20/2023]
Affiliation(s)
- Tobias Klatte
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Mesut Remzi
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | | | | | - Jonathan W. Said
- Department of Pathology and Laboratory Medicine, University of California-Los Angeles, Los Angeles, California
| | - Fairooz F. Kabbinavar
- Department of Medicine, University of California-Los Angeles, Los Angeles, California
| | - Andrea Haitel
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Matthias Waldert
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | | | - Michael Marberger
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Arie S. Belldegrun
- Department of Urology, University of California-Los Angeles, Los Angeles, California
| | - Allan J. Pantuck
- Department of Urology, University of California-Los Angeles, Los Angeles, California
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28
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Antonelli A, Tardanico R, Balzarini P, Arrighi N, Perucchini L, Zanotelli T, Cozzoli A, Zani D, Cunico SC, Simeone C. Cytogenetic features, clinical significance and prognostic impact of type 1 and type 2 papillary renal cell carcinoma. ACTA ACUST UNITED AC 2010; 199:128-33. [DOI: 10.1016/j.cancergencyto.2010.02.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Revised: 01/23/2010] [Accepted: 02/08/2010] [Indexed: 01/20/2023]
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Fuhrman Grade Provides Higher Prognostic Accuracy Than Nucleolar Grade for Papillary Renal Cell Carcinoma. J Urol 2010; 183:2143-7. [DOI: 10.1016/j.juro.2010.02.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Indexed: 01/09/2023]
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30
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Herrmann E, Trojan L, Becker F, Wülfing C, Schrader AJ, Barth P, Stöckle M, Hammerschmied CG, Staehler M, Stief C, Haferkamp A, Hohenfellner M, Legal W, Wullich B, Bolenz C, Klein T, Noldus J, Bierer S, Hertle L, Brenner W, Roos F, Michel MS, Walter B, Wieland W, Gerss J, Otto W, Hartmann A. Prognostic Factors of Papillary Renal Cell Carcinoma: Results From a Multi-Institutional Series After Pathological Review. J Urol 2010; 183:460-6. [DOI: 10.1016/j.juro.2009.10.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Indexed: 01/20/2023]
Affiliation(s)
- Edwin Herrmann
- Department of Urology, University of Münster, Münster, Germany
| | - Lutz Trojan
- Department of Urology, University Medical Centre Mannheim, Mannheim, Germany
| | - Frank Becker
- Department of Urology, University of Homburg, Homburg, Germany
| | | | | | - Peter Barth
- Institute of Pathology, University of Marburg, Marburg, Germany
| | - Michael Stöckle
- Department of Urology, University of Munich, Munich, Germany
| | | | | | - Christian Stief
- Department of Urology, University of Munich, Munich, Germany
| | - Axel Haferkamp
- Department of Urology, University of Heidelberg, Heidelberg, Germany
- Institute of Pathology, University of Erlangen, Erlangen, Germany
| | | | - Wolfgang Legal
- Department of Urology, University of Erlangen, Erlangen, Germany
| | - Bernd Wullich
- Department of Urology, University of Erlangen, Erlangen, Germany
| | - Christian Bolenz
- Department of Urology, University Medical Centre Mannheim, Mannheim, Germany
| | - Tobias Klein
- Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany
| | - Stefan Bierer
- Department of Urology, University of Münster, Münster, Germany
| | - Lothar Hertle
- Department of Urology, University of Münster, Münster, Germany
| | | | - Frederik Roos
- Department of Urology, University of Mainz, Mainz, Germany
| | - Maurice S. Michel
- Department of Urology, University Medical Centre Mannheim, Mannheim, Germany
| | - Bernhard Walter
- Department of Urology, University of Erlangen, Erlangen, Germany
| | - Wolf Wieland
- Department of Urology, University of Regensburg, Regensburg, Germany
| | - Joachim Gerss
- Department of Medical Informatics and Biomathematics, University of Münster, Münster, Germany
| | - Wolfgang Otto
- Department of Urology, University of Regensburg, Regensburg, Germany
| | - Arndt Hartmann
- Institute of Pathology, University of Erlangen, Erlangen, Germany
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