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Cirillo L, Innocenti S, Becherucci F. Global epidemiology of kidney cancer. Nephrol Dial Transplant 2024; 39:920-928. [PMID: 38341277 DOI: 10.1093/ndt/gfae036] [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: 08/04/2023] [Indexed: 02/12/2024] Open
Abstract
Kidney cancer (KC) is a disease with a rising worldwide incidence estimated at 400 000 new cases annually, and a worldwide mortality rate approaching 175 000 deaths per year. Current projections suggest incidence continuing to increase over the next decade, emphasizing the urgency of addressing this significant global health trend. Despite the overall increases in incidence and mortality, striking social disparities are evident. Low- and middle-income countries bear a disproportionate burden of the disease, with higher mortality rates and later-stage diagnoses, underscoring the critical role of socioeconomic factors in disease prevalence and outcomes. The major risk factors for KC, including smoking, obesity, hypertension and occupational exposure to harmful substances, must be taken into account. Importantly, these risk factors also often contribute to kidney injury, a condition that the review identifies as a significant, yet under-recognized, precursor to KC. Finally, the indispensable role of nephrologists is underscored in managing this complex disease landscape. Nephrologists are at the forefront of detecting and managing kidney injuries, and their role in mitigating the risk of KC is becoming increasingly apparent. Through this comprehensive analysis, we aim to facilitate a more nuanced understanding of KC's epidemiology and determinants providing valuable insights for researchers, clinicians and policymakers alike.
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Affiliation(s)
- Luigi Cirillo
- Nephrology and Dialysis Department, Meyer Children's Hospital IRCCS, Florence 50139, Italy
| | - Samantha Innocenti
- Nephrology and Dialysis Department, Meyer Children's Hospital IRCCS, Florence 50139, Italy
| | - Francesca Becherucci
- Nephrology and Dialysis Department, Meyer Children's Hospital IRCCS, Florence 50139, Italy
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
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Vazquez LC, Xi Y, Rasmussen RG, Venzor JER, Kapur P, Zhong H, Dai JC, Morgan TN, Cadeddu JA, Pedrosa I. Characterization of Demographical Histologic Diversity in Small Renal Masses With the Clear Cell Likelihood Score. J Comput Assist Tomogr 2024; 48:370-377. [PMID: 38213063 DOI: 10.1097/rct.0000000000001567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
OBJECTIVE This study aimed to develop a diagnostic model to estimate the distribution of small renal mass (SRM; ≤4 cm) histologic subtypes for patients with different demographic backgrounds and clear cell likelihood score (ccLS) designations. MATERIALS AND METHODS A bi-institution retrospective cohort study was conducted where 347 patients (366 SRMs) underwent magnetic resonance imaging and received a ccLS before pathologic confirmation between June 2016 and November 2021. Age, sex, race, ethnicity, socioeconomic status, body mass index (BMI), and the ccLS were tabulated. The socioeconomic status for each patient was determined using the Area Deprivation Index associated with their residential address. The magnetic resonance imaging-derived ccLS assists in the characterization of SRMs by providing a likelihood of clear cell renal cell carcinoma (ccRCC). Pathological subtypes were grouped into four categories (ccRCC, papillary renal cell carcinoma, other renal cell carcinomas, or benign). Generalized estimating equations were used to estimate probabilities of the pathological subtypes across different patient subgroups. RESULTS Race and ethnicity, BMI, and ccLS were significant predictors of histology (all P < 0.001). Obese (BMI, ≥30 kg/m 2 ) Hispanic patients with ccLS of ≥4 had the highest estimated rate of ccRCC (97.1%), and normal-weight (BMI, <25 kg/m 2 ) non-Hispanic Black patients with ccLS ≤2 had the lowest (0.2%). The highest estimated rates of papillary renal cell carcinoma were found in overweight (BMI, 25-30 kg/m 2 ) non-Hispanic Black patients with ccLS ≤2 (92.3%), and the lowest, in obese Hispanic patients with ccLS ≥4 (<0.1%). CONCLUSIONS Patient race, ethnicity, BMI, and ccLS offer synergistic information to estimate the probabilities of SRM histologic subtypes.
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Affiliation(s)
| | - Yin Xi
- From the Department of Radiology, University of Texas Southwestern School of Medicine
| | - Robert G Rasmussen
- From the Department of Radiology, University of Texas Southwestern School of Medicine
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Marchak K, Singh D, Malavia M, Trivedi P. A Review of Healthcare Disparities Relevant to Interventional Radiology. Semin Intervent Radiol 2023; 40:427-436. [PMID: 37927511 PMCID: PMC10622245 DOI: 10.1055/s-0043-1775878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Racial, ethnic, and gender disparities have received focused attention recently, as they became more visible in the COVID era. We continue to learn more about how healthcare disparities manifest for our patients and, more broadly, the structural underpinnings that result in predictable outcomes gaps. This review summarizes what we know about disparities relevant to interventional radiologists. The prevalence and magnitude of disparities are quantified and discussed where relevant. Specific examples are provided to demonstrate how factors like gender, ethnicity, social status, geography, etc. interact to create inequities in the delivery of interventional radiology (IR) care. Understanding and addressing health disparities in IR is crucial for improving real-world patient outcomes and reducing the economic burden associated with ineffective and low-value care. Finally, the importance of intentional mentorship, outreach, education, and equitable distribution of high-quality healthcare to mitigate these disparities and promote health equity in interventional radiology is discussed.
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Affiliation(s)
- Katherine Marchak
- Division of Interventional Radiology, Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Davinder Singh
- Division of Diagnostic Radiology/Department of Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mira Malavia
- University of Missouri, Kansas City School of Medicine, Kansas City, Missouri
| | - Premal Trivedi
- Division of Interventional Radiology, Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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Ikuemonisan J, Aremu TO, Oyejinmi I, Ajala C, Anikpezie N, Akinso O, Mtengwa M, David A, Olokede O, Adejoro O. Racial disparities in nephrectomy and mortality among patients with renal cell carcinoma: Findings from SEER. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001314. [PMID: 37220141 DOI: 10.1371/journal.pgph.0001314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/06/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE To assess racial differences in the receipt of nephrectomy in patients diagnosed RCC in the US. MATERIALS AND METHODS 2005 to 2015 data from the SEER database was analyzed and 70,059 patients with RCC were identified. We compared demographic and tumor characteristics between black patients and white patients. We applied logistic regression to assess the association between race and the odds of the receipt of nephrectomy. We also applied Cox proportional hazards model to assess the impact of race on cancer-specific mortality (CSM) and all-cause mortality (ACM) in patients diagnosed with RCC in the US. RESULTS Black patients had 18% lower odds of receiving nephrectomy compared to white patients (p < 0.0001). The odds of the receipt of nephrectomy also reduced with age at diagnosis. In addition, patients with T3 stage had the greatest odds of receiving nephrectomy when compared to T1 (p < 0.0001). There was no difference in the risk of cancer-specific mortality between black patients and white patients; black patients had 27% greater odds of all-cause mortality than white patients (p < 0.0001). Patients who did not receive nephrectomy had a 42% and 35% higher risk of CSM and ACM respectively, when compared to patients who received nephrectomy. CONCLUSIONS Black patients diagnosed with RCC in the US have a greater ACM risk and are less likely than white patients to receive nephrectomy. Systemic changes are needed to eliminate racial disparity in the treatment and outcomes of RCC in the US.
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Affiliation(s)
- Joshua Ikuemonisan
- Division of Tobacco Research and Prevention, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Taiwo Opeyemi Aremu
- Department of Pharmaceutical Care & Health Systems (PCHS), University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Children's Hospital, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Isaac Oyejinmi
- Hospital Data and Analytics, HealthPartners, St Louis Park, Minnesota, United States of America
| | - Christopher Ajala
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Nnabuchi Anikpezie
- Department of Population Health Science, The University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Oyindamola Akinso
- Department of Public Health, Nova SouthEastern University, Fort Lauderdale, Florida, United States of America
| | - Mutsa Mtengwa
- Department of women's Health, Greater Baltimore Medical Center, Baltimore, Maryland, United States of America
| | - Adeyemo David
- Department of Nursing, Indiana Wesleyan University, Marion, Indiana, United States of America
| | - Olugbenga Olokede
- F. Maie Hall Institute for Rural and Community Health, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Oluwakayode Adejoro
- Market Access, Janssen Global Services, LLC, Horsham, Philadelphia, United States of America
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Zhou S, Lu Y, Chen Y, Gan W. Identification of an immunogenic cell death-related gene signature predicts survival and sensitivity to immunotherapy in clear cell renal carcinoma. Sci Rep 2023; 13:4449. [PMID: 36932108 PMCID: PMC10023707 DOI: 10.1038/s41598-023-31493-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Immunogenic cell death (ICD) is the trigger of adaptive immune responses. However, the role of ICD-related genes in clear cell renal carcinoma (ccRCC) remains unclear. We aimed to identify biomarkers associated with ICD and develop an ICD-related predictive model that predicts the immune microenvironment, prognosis, and response to immunotherapy in ccRCC. Our study included 739 patients (603 in the training set and 136 in the validation set) with clinicopathologic information and transcriptome sequencing data. Consensus clustering, principal component analysis (PCA), weighted gene co-expression network analysis (WGCNA), univariate COX analysis, multivariate COX analysis, and the Lasso-Cox algorithm were applied to shrink predictors and construct a predictive signature of overall survival (OS). We used CIBERSORT, ESTIMATE, and TIMER in the R package IOBR to evaluate the tumor microenvironment and immune infiltration pattern of each sample. Finally, the single cell sequencing results of immune cells in ccRCC were used to verify the results of immune infiltration analysis, and the performance of the prognostic model was evaluated by calibration curves and c-index. This study revealed that inability of the initial immune response and primary immunodeficiency were significantly enriched in the ICD subgroup with poor prognosis. We found that the ten candidate ICD genes (CALR, ENTPD1, FOXP3, HSP90AA1, IFNB1, IFNG, IL6, LY96, PIK3CA, and TLR4) could affect the prognosis of ccRCC (p < 0.05). The prediction model (PRE) we constructed can not only predict the long-term survival probability but also evaluate the landscape of immune infiltration in ccRCC. Our study demonstrated that low infiltration of dendritic cells in ccRCC implies a poor prognosis, whereas the degree of CTL infiltration is less important. An individualized prediction model was created to predict the 1-, 2-, 3-, and 5-year survival and responsiveness of ccRCC patients to immunotherapy, which may serve as a potent tool for clinicians to make better treatment decisions and thus improve the overall survival (OS) of ccRCC patients in the future.
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Affiliation(s)
- Shuoming Zhou
- Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yanwen Lu
- Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuxin Chen
- Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weidong Gan
- Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
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Screening for Coronary Artery Disease in Cancer Survivors: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2023; 5:22-38. [PMID: 36875910 PMCID: PMC9982229 DOI: 10.1016/j.jaccao.2022.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 02/24/2023] Open
Abstract
Coronary artery disease (CAD) is an important contributor to the cardiovascular burden in cancer survivors. This review identifies features that could help guide decisions about the benefit of screening to assess the risk or presence of subclinical CAD. Screening may be appropriate in selected survivors based on risk factors and inflammatory burden. In cancer survivors who have undergone genetic testing, polygenic risk scores and clonal hematopoiesis markers may become useful CAD risk prediction tools in the future. The type of cancer (especially breast, hematological, gastrointestinal, and genitourinary) and the nature of treatment (radiotherapy, platinum agents, fluorouracil, hormonal therapy, tyrosine kinase inhibitors, endothelial growth factor inhibitors, and immune checkpoint inhibitors) are also important in determining risk. Therapeutic implications of positive screening include lifestyle and atherosclerosis interventions, and in specific instances, revascularization may be indicated.
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Key Words
- ACS, acute coronary syndrome
- AYA, adolescent and young adult
- CAC, coronary artery calcium
- CAD, coronary artery disease
- CHIP, clonal hematopoiesis of indeterminate potential
- CMR, cardiac magnetic resonance
- CTA, computed tomography angiography
- CVD, cardiovascular disease
- IGF, insulin-like growth factor
- LDL, low-density lipoprotein
- PCE, pooled cohort equations
- PCI, percutaneous coronary intervention
- PRS, polygenic risk score
- ROS, reactive oxygen species
- TKI, tyrosine kinase inhibitor
- VEGF, vascular endothelial growth factor
- calcification
- coronary artery calcium
- coronary artery disease
- prevention
- risk factor
- risk prediction
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Development of a Novel KCNN4-Related ceRNA Network and Prognostic Model for Renal Clear Cell Carcinoma. Anal Cell Pathol 2023. [DOI: 10.1155/2023/2533992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background. Clear cell renal cell carcinoma (ccRCC) accounts for more than 80% of renal cell carcinomas. Yet, it has not been fully understood about the derivation and progression of the tumor, as well as the long-term benefits from multimodality therapy. Therefore, reliable and applicable molecular markers are urgently needed for the prediction of diagnosis and prognosis of ccRCC patients. Methods. Genetic and clinical information of 533 ccRCC patients from The Cancer Genome Atlas database was collected for comprehensive bioinformatic analyses. UALCAN was used to detect gene expression in paired tumor samples. Two data sets from Gene Expression Omnibus database were analyzed to identify differentially expressed genes (DEGs), and Gene Set Enrichment Analysis was applied for the functional enrichment of DEGs. Tumor Immune Single Cell Hub and Tumor IMmune Estimation Resource databases were separately used for analyses of single-immune cell and immune cell infiltration. Encyclopedia of RNA Interactomes database was explored to predict targeted microRNAs (miRNAs) and corresponding long non-coding RNAs (lncRNAs). Cox regression analysis was performed for the construction of risk signature and prognosis model. Finally, quantitative real-time polymerase chain reaction and western blot were conducted for KCNN4 expression detection in cell lines and clinical samples. Small interfering RNA was employed to knock down KCNN4, and corresponding functional experiments were conducted on ccRCC cells as well. Results. KCNN4 showed elevated expression in tumors and prominent clinical correlation in ccRCC. In total, 41 KCNN4-related genes were enriched, and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed they were intimately related to immune-related signaling pathways. Spearman’s analysis revealed the significantly positive correlation of KCNN4 with immune cell infiltration. By integrating hub miRNA-let-7e-5p and four critical lncRNA, a competitive endogenous RNA network-based risk signature was constructed. The prognosis model derived from it showed considerable predictive value for survival of ccRCC patients. Finally, in vitro experiments confirmed the remarkable tumor-promoting role of KCNN4 in ccRCC cells. Conclusion. KCNN4 significantly affected the immune status of tumor microenvironment and immunotherapy elements, through which it promoted tumor progression in ccRCC, and it could be a potential biomarker for prognosis and immunotherapy effects of ccRCC patients.
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Ma X, Sun L. Construction and Validation of Protein Expression-related Prognostic Models in Clear Cell Renal Cell Carcinoma. J Cancer 2023; 14:793-808. [PMID: 37056387 PMCID: PMC10088890 DOI: 10.7150/jca.81915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/19/2023] [Indexed: 04/15/2023] Open
Abstract
Objective: To construct a prognostic evaluation model for clear cell renal cell carcinoma (ccRCC) patients using bioinformatics method and to screen potential drugs for ccRCC. Methods: ccRCC RNA sequencing data, clinical data, and protein expression data were downloaded from the TCGA database. Univariate Cox and Lasso regression analyses were performed on the combined data to screen out the proteins related to the prognosis, and they were included in a multivariate Cox proportional hazard model. The patients were divided into high and low-risk groups for a survival difference analysis. The predictive power of the model was evaluated on the basis of overall survival, progression-free survival, independent prognostic, clinically relevant receiver operating characteristic (ROC) curve, C-index, principal component, and clinical data statistics analyses. GSEA enrichment and immune function correlation analyses were performed. The samples were divided into different subtypes based on the expression of the risk proteins, and survival analysis of the subtypes was performed. The risk-related protein and RNA sequencing data were analyzed to screen out sensitive drugs with significant differences between the high and low-risk groups. Results: A total of 469 ccRCC-related proteins were screened, of which 13 proteins with independent prognostic significance were screened by univariate Cox, Lasso, and multivariate Cox regression analyses to construct the prognostic model. The sensitivity and accuracy of the model in predicting the survival of patients with ccRCC were high (1 year: 0.811, 3 years: 0.783, 5 years: 0.777). The 13 proteins were closely related to immunity, and the model proteins were different between kidney and tumor tissues according to the HPA database. The samples were divided into three subtypes, and there were obvious clinical characteristics of the three subtypes in the grade and T, N and M stages. According to the IC50 values, CGP-60474, vinorelbine, doxorubicin, etoposide, FTI-277, JQ12, OSU-03012, pyrimethamine, and other drugs were more sensitive in the high-risk group. Conclusions: A prognostic model of protein expression in ccRCC was successfully constructed, which had good predictive ability for the prognosis of ccRCC patients. The ccRCC-related proteins in the model can be used as targets for studying the pathogenesis and targeted therapy.
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Affiliation(s)
| | - Libin Sun
- ✉ Corresponding author: Libin Sun, Department of Urology, Affiliated First Hospital of Shanxi Medical University, 85 South Jiefang Rd, Taiyuan, Shanxi Province, 030001, China. Tel: +86-15698579398; Email address:
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Mutuiri A, Gakinya S. Clinicopathologic features of renal cell carcinomas seen at the Aga Khan University Hospital in Kenya. Front Med (Lausanne) 2022; 9:981305. [DOI: 10.3389/fmed.2022.981305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
IntroductionKidney cancer accounted for 1. 8% of global cancer deaths according to Globocan 2020 estimates, with most of these being renal cell carcinomas. Lower rates of renal cell carcinoma are reported for Africa and these are expected to change for a combination of reasons. The clinical and morphologic characteristics of renal cell carcinoma seen within Kenya have not been described before. This study aims to partially fill this gap.Materials and methodsThis was a cross-sectional descriptive study examining electronic histopathology reports from the Aga Khan University Hospital Nairobi Laboratory for the period January 2016 to May 2022.ResultsSixty cases of renal cell carcinoma were identified. The mean age at diagnosis was 55.3 years. The most common histologic subtype diagnosed was clear cell renal cell carcinoma (41.7%), followed by papillary renal cell carcinoma and renal cell carcinoma not further specified (both 21.7%), and chromophobe renal cell carcinoma (11.7%). The most frequent specimen type was resection, followed by cores of renal masses. The mean tumor size was 8.5 cm. Sixty-seven percent of patients presented with Stage III and above.DiscussionRenal masses were the commonest clinical indication for biopsy among the records reviewed. The male to female ratio, as well as the mean age at presentation were comparable to what is described in literature for other regions of the world. The proportions of the commonest histologic subtypes matched what is described in other parts of the world. Challenges in the identification of histologic subtypes included having a limited panel of antibodies for diagnosis and the lack of genetic molecular tests for histotyping.ConclusionThe spectrum of histologic subtypes of renal cell carcinoma seen at a tertiary referral hospital in Nairobi, Kenya was similar to that described in other parts of Africa and the globe. The age at presentation with renal cell carcinoma was consistent with what has been described in literature. Challenges were identified in the accurate histotyping of renal cell carcinoma due to constrained resources. Majority of cases diagnosed presented at advanced stage.
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Du S, Zhong Y, Zheng S, Lyu J. Analysis and Prediction of the Survival Trends of Patients with Clear-Cell Renal Cell Carcinoma: A Model-Based Period Analysis, 2001-2015. Cancer Control 2022; 29:10732748221121226. [PMID: 35981235 PMCID: PMC9393668 DOI: 10.1177/10732748221121226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Clear-cell renal cell carcinoma (ccRCC) is one of the most common malignant
tumors worldwide whose poor prognosis results in a serious disease burden on
patients. The changing trend of the long-term relative survival rates (RSRs)
of patients with ccRCC was analyzed in this study to evaluate their
treatment results over a 15-year period. Methods This study is a retrospective study, which assessed and predicted the 1-, 3-,
and 5-year survival rates of patients with ccRCC during 2001-2005,
2006-2010, 2011-2015, and 2016-2020 using data extracted from the
Surveillance, Epidemiology, and End Results (SEER) database. Period analysis
was used in this study to analyze the data from the SEER database and to
assess survival differences according to age, sex, race, and socioeconomic
status (SES) during the 15-year study period by comparing Kaplan-Meier
curves. Results During 2001-2015, the 5-year RSR of patients with ccRCC increased from 78.4%
to 83.0%, and the generalized linear model predicted that the 5-year RSR
increased to 85.7% during 2016-2020. The RSR of patients with ccRCC differed
significantly with SES, race, sex, and age. Compared with male patients, the
survival advantage of female patients decreased as their age increased. The
RSR of all patients with ccRCC was also lower in patients with a lower SES
and of black race. Conclusion This study found an improvement in the RSR of patients with ccRCC during
2001-2020. Understanding the change trend of the survival rate of patients
with ccRCC is helpful to improve the design of clinical trials. It also
provides basic data and a scientific basis for evaluating the harm of ccRCC
on the health of affected patients and the effect of cancer prevention, and
developing cancer prevention plans.
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Affiliation(s)
- Sicong Du
- Zhongshan School of Medicine, 74644Sun Yat-sen University, Guangzhou, People's Republic of China.,Department of Clinical Research, 107652The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Yu Zhong
- School of Public Health, 107652Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Shuai Zheng
- School of Public Health, 107652Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Jun Lyu
- Department of Clinical Research, 107652The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
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Bossé D, Xie W, Lin X, Simantov R, Lalani AKA, Graham J, Wells JC, Donskov F, Rini B, Beuselinck B, Alva A, Hansen A, Wood L, Soulières D, Kollmannsberger C, Patenaude F, Heng DYC, Choueiri TK, McKay RR. Outcomes in Black and White Patients With Metastatic Renal Cell Carcinoma Treated With First-Line Tyrosine Kinase Inhibitors: Insights From Two Large Cohorts. JCO Glob Oncol 2021; 6:293-306. [PMID: 32109159 PMCID: PMC7055470 DOI: 10.1200/jgo.19.00380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To investigate whether black race is an independent predictor of overall survival (OS) in metastatic renal cell carcinoma (mRCC). METHODS We performed a retrospective 2-cohort (International Metastatic Renal Cell Carcinoma Database Consortium [IMDC] and trial-database) study of patients with mRCC treated with first-line tyrosine kinase inhibitors (TKIs). Unmatched (UM) and matched (M) analyses accounting for imbalances in region, year of treatment, age, and sex between races were performed. Cox models adjusting for histology, number of metastatic sites, nephrectomy, and IMDC risk compared time to treatment failure (TTF; IMDC cohort), progression-free survival (PFS; trial-database cohort), and OS. RESULTS The IMDC cohort included 73 black versus 3,381 (UM) and 1,236 (M) white patients. The trial-database cohort included 21 black versus 1,040 (UM) and 431 (M) white patients. Median OS for black versus white patients was 18.5 versus 25.8 months in the IMDC group and 21.0 versus 25.6 months in the trial-database group. Differences in OS were not significant in multivariable analysis in the IMDC group (hazard ratio [HR]M, 1.0; 95% CI, 0.7 to 1.5; HRUM, 1.1; 95% CI, 0.8 to 1.4) and trial-database (HRM, 1.5; 95% CI, 0.8 to 2.7; HRUM, 1.4; 95% CI, 0.8 to 2.6) cohorts. TTF for black patients was shorter in the UM IMDC cohort (HRUM, 1.4; 95% CI, 1.1 to 1.8; P = .003), but not in the M analysis. PFS was shorter for black patients in both analyses in the trial-database cohort (HRM, 2.3; 95% CI, 1.4 to 3.9; P = .002; HRUM, 2.3; 95% CI, 1.4 to 3.9; P = .002). CONCLUSION Black patients had more IMDC risk factors and worse outcomes with TKIs versus white patients. Race was not an independent predictor of OS. Strategies to understand biologic determinants of outcomes for minority patients are needed to optimize care.
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Affiliation(s)
- Dominick Bossé
- The Ottawa Hospital, Division of Medical Oncology, University of Ottawa, Ottawa, Ontario, Canada.,Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Wanling Xie
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Xun Lin
- Pfizer Oncology, La Jolla, CA
| | | | - Aly-Khan A Lalani
- Juravinski Cancer Centre, Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | | | - J Connor Wells
- Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | | | - Brian Rini
- Department of Hematology and Medical Oncology, Cleveland Clinic-Taussig Cancer Institute, Cleveland, OH
| | - Benoit Beuselinck
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Aaron Hansen
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Lori Wood
- Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Denis Soulières
- Centre Hospitalier de l'Université de Montréal, Division of Oncology, Montreal, Quebec, Canada
| | | | - Francois Patenaude
- Department of Oncology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Daniel Y C Heng
- University of California San Diego, Moores Cancer Center, San Diego, CA
| | - Toni K Choueiri
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Rana R McKay
- University of California San Diego, Moores Cancer Center, San Diego, CA
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Chen S, Wang C, Su X, Dai X, Li S, Mo Z. KCNN4 is a potential prognostic marker and critical factor affecting the immune status of the tumor microenvironment in kidney renal clear cell carcinoma. Transl Androl Urol 2021; 10:2454-2470. [PMID: 34295732 PMCID: PMC8261455 DOI: 10.21037/tau-21-332] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background The tumor microenvironment (TME) has emerged as a crucial factor in cancer development and progression. Recent findings have indicated that tumor-infiltrating immune cells (TICs) in the TME may predict cancer prognosis and response to treatment. Herein, we sought to identify critical modulators of the kidney renal clear cell carcinoma (KIRC) TME. Methods KIRC datasets from The Cancer Genome Atlas (TCGA) were analyzed using the ESTIMATE algorithm to determine the ImmuneScore and StromalScore. By profiling the differentially expressed genes (DEGs) in the ImmuneScore and StromalScore, we finally identified the immune- and stromal-related DEGs of the cases, through which we then performed intersection analysis to determine the immune-related genes (IRGs). Cox regression analysis and least absolute shrinkage and selection operator (LASSO) regression analysis were used to identify critical IRGs and construct a prognostic model. The CIBERSORT algorithm was used to calculate the relative content of 22 immune cell types. Finally, the datasets from the Gene Expression Omnibus (GEO) database were analyzed to validate results from the above analyses. Experimental validation was used on KIRC tissues by quantitative polymerase chain reaction (qPCR) and western blot. Results We found that the ImmuneScore was negatively correlated with patients’ prognosis. Intersection analysis of the ImmuneScore and StromalScore identified 118 IRGs that were enriched in immune-related functions. Following IRGs screening by Cox and LASSO regression analyses, six genes were identified and used to construct a KIRC prognostic model. Intersection analysis of these six genes and protein-protein interaction (PPI) were performed and obtained the most critical gene: Potassium Calcium-Activated Channel Subfamily N Member 4 (KCNN4). Further analysis showed that KCNN4 expression was higher in tumor samples relative to normal controls, and was negatively correlated with prognosis. CIBERSORT analysis revealed significant correlation between KCNN4 expression and multiple types of TICs, demonstrating that KCNN4 may affect KIRC prognosis by influencing the TME immune status. Ultimately, the GEO datasets and validation experiments confirmed that KCNN4 was highly expressed in tumor tissues compared to the corresponding normal tissues. Conclusions Our study demonstrated that KCNN4 might be a potential prognostic marker in KIRC, offering a novel therapeutic avenue.
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Affiliation(s)
- Shaohua Chen
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China
| | - Chengbang Wang
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China
| | - Xiaotao Su
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaodi Dai
- Guangxi Medical University, Nanning, China
| | - Songheng Li
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zengnan Mo
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, China
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13
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Suss NR, Bruha MJ, Monaghan TF, Robins D, Flores V, Agudelo CW, Smith M, Hyacinthe L, McNeil BK, Weiss J, Winer A. Assessing the role of race in pathological upstaging of renal cell carcinoma: Results from the National Cancer Database. Int J Clin Pract 2021; 75:e13818. [PMID: 33159366 DOI: 10.1111/ijcp.13818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/02/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Pathologic upstaging in renal cell carcinoma (RCC) is common and confers a significant risk of poor surgical and survival outcomes. Preoperative predictors of upstaging are of great clinical relevance but empirical evidence specific to racial minorities remains scarce. METHODS National Cancer Database (NCDB) analysis of T3a-specific upstaging among White, African-American, Hispanic and Asian Pacific Islander (API) patients with AJCC cT1N0M0 RCC who underwent partial or radical nephrectomy between 2010 and 2015. Independent preoperative predictors of tumour upstaging were identified using multivariate logistic regression analyses. RESULTS A total of 81 002 patients met the criteria for inclusion (5.6% T3a-specific upstaging). Increased age, increased Charlson-Deyo comorbidity index, clinical stages cT1b and unspecified cT1, and increased Fuhrman nuclear grade were identified as independent risk factors for upstaging. Independent protective factors for upstaging were younger age, female sex, African-American race and papillary, chromophobe, and unspecified RCC histologic subtypes. Significant risk factors and protective factors within individual racial subgroups were highly consistent with those observed in the overall study sample. All independent factors identified on race-specific subgroup analyses were significant in the same direction relative to the overall study sample. Variables found to be non-significant in the overall study sample remained non-significant across all racial subgroup analyses. CONCLUSION The present study of nationally representative data found no clinically significant differences in upstaging risk across individual racial subgroups relative to the overall study sample. Preoperative factors that can be used to predict pT3a-specific tumour upstaging in CT1N0M0 RCC likely persist across different racial groups.
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Affiliation(s)
- Nicholas R Suss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Matthew J Bruha
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Dennis Robins
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Viktor Flores
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Christina W Agudelo
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Matthew Smith
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Llewellyn Hyacinthe
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Brian K McNeil
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jeffrey Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Andrew Winer
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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14
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Du Z, Chen W, Xia Q, Shi O, Chen Q. Trends and projections of kidney cancer incidence at the global and national levels, 1990-2030: a Bayesian age-period-cohort modeling study. Biomark Res 2020; 8:16. [PMID: 32435498 PMCID: PMC7222434 DOI: 10.1186/s40364-020-00195-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Identifying the temporal trends of kidney cancer (KC) incidence in both the past and the future at the global and national levels is critical for KC prevention. Methods We retrieved annual KC case data between 1990 and 2017 from the Global Burden of Disease (GBD) online database. The average annual percentage change (AAPC) was used to quantify the temporal trends of KC age-standardized incidence rates (ASRs) from 1990 to 2017. Bayesian age-period-cohort models were used to predict KC incidence through 2030. Results Worldwide, the number of newly diagnosed KC cases increased from 207.3 thousand in 1990 to 393.0 thousand in 2017. The KC ASR increased from 4.72 per 100,000 to 4.94 per 100,000 during the same period. Between 2018 and 2030, the number of KC cases is projected to increase further to 475.4 thousand (95% highest density interval [HDI] 423.9, 526.9). The KC ASR is predicted to decrease slightly to 4.46 per 100,000 (95% HDI 4.06, 4.86). A total of 90, 2, and 80 countries or territories are projected to experience increases, remain stable, and experience decreases in KC ASR between 2018 and 2030, respectively. In most developed countries, the KC incidence is forecasted to decrease irrespective of past trends. In most developing countries, the KC incidence is predicted to increase persistently through 2030. Conclusions KC incidence is predicted to decrease in the next decade, and this predicted decrease is mainly driven by the decreases in developed countries. More attention should be placed on developing countries.
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Affiliation(s)
- Zhebin Du
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
| | - Wei Chen
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
| | - Qier Xia
- 2Department of Urology, Pudong New Area People's Hospital, Shanghai, China
| | - Oumin Shi
- 3Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518020 China
| | - Qi Chen
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
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15
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Falagario UG, Martini A, Pfail J, Treacy PJ, Okhawere KE, Dayal BD, Sfakianos JP, Abaza R, Eun DD, Bhandari A, Porter JR, Hemal AK, Badani KK. Does race impact functional outcomes in patients undergoing robotic partial nephrectomy? Transl Androl Urol 2020; 9:863-869. [PMID: 32420201 PMCID: PMC7214979 DOI: 10.21037/tau.2019.09.31] [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] [Indexed: 12/15/2022] Open
Abstract
Background The role of race on functional outcomes after robotic partial nephrectomy (RPN) is still a matter of debate. We aimed to evaluate the clinical and pathologic characteristics of African American (AA) and Caucasian patients who underwent RPN and analyzed the association between race and functional outcomes. Methods Data was obtained from a multi-institutional database of patients who underwent RPN in 6 institutions in the USA. We identified 999 patients with complete clinical data. Sixty-three patients (6.3%) were AA, and each patient was matched (1:3) to Caucasian patients by age at surgery, gender, Charlson Comorbidity Index (CCI) and renal score. Bivariate and multivariate logistic regression analyses were used to evaluate predictors of acute kidney injury (AKI). Kaplan-Meier method and multivariable semiparametric Cox regression analyses were performed to assess prevalence and predictors of significant eGFR reduction during follow-up. Results Overall, 252 patients were included. AA were more likely to have hypertension (58.7% vs. 35.4%, P=0.001), even after 1:3 match. Overall 42 patients (16.7%) developed AKI after surgery and 35 patients (13.9%) developed significant eGFR reduction between 3 and 15 months after RAPN. On multivariate analysis, AA race did not emerge as a significant factor for predicting AKI (OR 1.10, P=0.8). On Cox multivariable analysis, only AKI was found to be associated with significant eGFR reduction between 3 and 15 months after RAPN (HR 2.49, P=0.019). Conclusions Although African American patients were more likely to have hypertension, renal function outcomes of robotic partial nephrectomies were not significantly different when stratified by race. However, future studies with larger cohorts are necessary to validate these findings.
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Affiliation(s)
- Ugo G Falagario
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Urology, University of Foggia, Foggia, Italy
| | - Alberto Martini
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - John Pfail
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Kennedy E Okhawere
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bheesham D Dayal
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John P Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ronney Abaza
- Robotic Urologic Surgery, Ohio Health Dublin Methodist Hospital, Columbus, OH, USA
| | - Daniel D Eun
- Department of Urology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Akshay Bhandari
- Division of Urology, Columbia University at Mount Sinai, Miami Beach, FL, USA
| | | | - Ashok K Hemal
- Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ketan K Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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16
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Das H, Rodriguez R. Health Care Disparities in Urologic Oncology: A Systematic Review. Urology 2020; 136:9-18. [DOI: 10.1016/j.urology.2019.09.058] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 12/21/2022]
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17
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Racial and ethnic differences in survival in contemporary metastatic renal cell carcinoma patients, according to alternative treatment modalities. Cancer Causes Control 2020; 31:263-272. [PMID: 31993859 DOI: 10.1007/s10552-020-01270-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE To test the association between African-American race and overall mortality (OM) rates in patients with metastatic renal cell carcinoma (mRCC). METHODS Within the Surveillance, Epidemiology, and End Results registry (2006-2015), we identified patients with clear cell (ccmRCC) and non-clear cell mRCC (non-ccmRCC). African-Americans, Caucasians, and Hispanics were identified. Stratification was made according to histology and treatments: (1) no treatment, (2) systemic therapy (ST), (3) cytoreductive nephrectomy (CNT), (4) CNT + ST. Kaplan-Meier plots and multivariable Cox regression analyses were used. RESULTS Of ccmRCC patients, 410 (7%), 4353 (75%), and 1005 (17%) were African-American, Caucasian, and Hispanic, respectively. Of non-ccmRCC patients, 183 (25%), 479 (65%), and 77 (10%) were African-American, Caucasian, and Hispanic, respectively. In ccmRCC, African-Americans were associated with higher OM rates (HR 1.20; 95% CI 1.05-1.37). Conversely, in non-ccmRCC, African-Americans were associated with lower OM rates (HR 0.75; 95% CI 0.59-0.97). CONCLUSION African-American race is associated with prolonged survival in non-ccmRCC, but it is also associated with lower survival rates in ccmRCC. The exception to these observations consisted of patients treated with combination of CNT + ST for either ccmRCC or non-ccmRCC.
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18
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Beltran E, Garcia-Robledo JE, Rodríguez-Rojas LX, Rengifo M, Perez B, Pachajoa H, Zambrano AR. Clear cell renal carcinoma synchronous with dedifferentiated liposarcoma: a case report and review of the literature. J Med Case Rep 2020; 14:4. [PMID: 31915049 PMCID: PMC6950918 DOI: 10.1186/s13256-019-2320-4] [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: 09/24/2019] [Accepted: 11/20/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Multiple primary malignant neoplasms are not frequent but are increasing in incidence. Some of them are associated with genetic syndromes such as von Hippel-Lindau syndrome and Li-Fraumeni syndrome. Dedifferentiated liposarcoma is one of the rarest soft tissue tumors, and clear cell renal carcinoma is the most frequent kidney cancer. The concomitant presence of these tumors is extremely rare; however, some cases have been reported, none of them presenting with liposarcoma of the limbs. We report an interesting case of a patient with synchronous multiple primary tumors presenting with a very rare liposarcoma associated with renal cell carcinoma (a very rare association). A review of the literature and a collection of similar cases published previously are also provided. CASE PRESENTATION We report a case of a 62-year-old Hispanic man who presented to our institution with a left thigh mass compatible with dedifferentiated liposarcoma synchronous with metastatic clear cell renal carcinoma. Multiple treatment lines were provided with no response, with a further metastatic transformation. Genetic analysis by liquid biopsy showed some mutations that were not susceptible to targeted therapy. At the time of this report, the patient is undergoing palliative care because his nonresponsive metastatic disease persists. CONCLUSIONS We present the first reported case of clear cell renal carcinoma synchronous with dedifferentiated liposarcoma of a limb. The association between renal cell carcinoma and dedifferentiated liposarcoma is unusual, and there are few reports of this presentation in the literature. More research about these tumors along with genetic tests needs to be performed to seek a better understanding of the fundamental basis of this rare association.
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Affiliation(s)
- Estefania Beltran
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia
| | - Juan Esteban Garcia-Robledo
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia. .,Hematology/Oncology Department, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia. .,Faculty of Health Sciences, Universidad Icesi, Cali, Calle 18 No. 122-135, Colombia.
| | - Lisa X Rodríguez-Rojas
- Human Genetics Department, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia
| | - Martin Rengifo
- Diagnostic Imaging Department, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia
| | - Bladimir Perez
- Pathology Department, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia
| | - Harry Pachajoa
- Human Genetics Department, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia
| | - Angela R Zambrano
- Hematology/Oncology Department, Fundación Valle del Lili, Cali, Carrera 98 No. 18-49, Colombia
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19
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Zheng T, Zhu C, Bassig BA, Liu S, Buka S, Zhang X, Truong A, Oh J, Fulton J, Dai M, Li N, Shi K, Qian Z, Boyle P. The long-term rapid increase in incidence of adenocarcinoma of the kidney in the USA, especially among younger ages. Int J Epidemiol 2019; 48:1886-1896. [PMID: 31317187 PMCID: PMC7967823 DOI: 10.1093/ije/dyz136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We previously observed a rapid increase in the incidence of renal cell carcinoma (RCC) in men and women between 1935 and 1989 in the USA, using data from the Connecticut Tumor Registry. This increase appeared to be largely explained by a positive cohort effect, but no population-based study has been conducted to comprehensively examine age-period-cohort effects by histologic types for the past decade. METHODS We calculated age-adjusted and age-specific incidence rates of the two major kidney-cancer subtypes RCC and renal urothelial carcinoma, and conducted an age-period-cohort analysis of 114 138 incident cases of kidney cancer reported between 1992 and 2014 to the Surveillance, Epidemiology, and End Results programme. RESULTS The age-adjusted incidence rates of RCC have been increasing consistently in the USA among both men and women (from 12.18/100 000 in 1992-1994 to 18.35/100 000 in 2010-2014 among men; from 5.77/100 000 in 1992-1994 to 8.63/100 000 in 2010-2014 among women). Incidence rates generally increased in successive birth cohorts, with a continuing increase in rates among the younger age groups (ages 0-54 years) in both men and women and among both Whites and Blacks. These observations were confirmed by age-period-cohort modelling, which suggested an increasing birth-cohort trend for RCC beginning with 1955 birth cohorts, regardless of the assumed value for the period effect for both men and women and for Whites and Blacks. CONCLUSIONS Known risk factors for kidney cancer may not fully account for the observed increasing rates or the birth-cohort pattern for RCC, prompting the need for additional etiologic hypotheses (such as environmental exposures) to investigate these descriptive patterns.
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Affiliation(s)
| | - Cairong Zhu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bryan A Bassig
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD, USA
| | - Simin Liu
- Brown School of Public Health, Providence, RI, USA
| | - Stephen Buka
- Brown School of Public Health, Providence, RI, USA
| | - Xichi Zhang
- George Washington University, Washington, DC, USA
| | | | - Junhi Oh
- Rhode Island Department of Health, Providence, RI, USA
| | - John Fulton
- Brown School of Public Health, Providence, RI, USA
| | - Min Dai
- China National Cancer Center, Beijing, 100021, China
| | - Ni Li
- China National Cancer Center, Beijing, 100021, China
| | - Kunchong Shi
- Brown School of Public Health, Providence, RI, USA
| | - Zhengmin Qian
- College for Public Health & Social Justice Saint Louis University, MO, USA
| | - Peter Boyle
- International Prevention Research Institute, Lyon, France
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20
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Nam GE, Cho KH, Han K, Kim CM, Han B, Cho SJ, Jung SJ, Kwon Y, Kim YH, Kim DH, Kim SM, Choi YS, Roh YK, Park YG. Obesity, abdominal obesity and subsequent risk of kidney cancer: a cohort study of 23.3 million East Asians. Br J Cancer 2019; 121:271-277. [PMID: 31231120 PMCID: PMC6738324 DOI: 10.1038/s41416-019-0500-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 05/10/2019] [Accepted: 05/21/2019] [Indexed: 12/17/2022] Open
Abstract
Background Limited evidence exists regarding associations between obesity and kidney cancer among Asians. We examined the associations between obesity measures and risk of kidney cancer. Methods We included 23,313,046 adults who underwent health examinations provided by the Korean National Health Insurance Service 2009–2012 and performed multivariable Cox proportional hazards regression analyses. Results During 5.4 years of follow-up, 18,036 cases of kidney cancer were recorded, and cumulative incidence was 0.12%. General and abdominal obesity were associated with 1.32-fold increased risk of kidney cancer compared with groups without either obesity status. Underweight individuals showed decreased adjusted hazard ratio (HR) for kidney cancer (0.76, 95% confidence interval: 0.68–0.85) compared to those with normal body mass index (BMI), while the HRs increased among individuals with BMI 23–24.9 kg/m2 (1.23, 1.18–1.28), 25–29.9 kg/m2 (1.41, 1.36–1.46) and ≥30 kg/m2 (1.77, 1.65–1.90) (P for trend < 0.001). HRs of kidney cancer increased with increasing waist circumference (WC) (P for trend < 0.001). Compared to non-obese condition, the coexistence of general and abdominal obesity increased the HR (1.45, 1.40–1.50). Conclusions This study demonstrated positive associations of BMI and WC with kidney cancer risk. General and abdominal obesity may be risk factors of kidney cancer.
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Affiliation(s)
- Ga Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung Hwan Cho
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Min Kim
- Department of Family Medicine, College of Medicine, The Catholic University of Korea Seoul, Seoul, Republic of Korea
| | - Byoungduck Han
- Department of Family Medicine, Sahmyook Medical Center, Seoul, Republic of Korea
| | - Sung Jung Cho
- Department of Family Medicine, Sahmyook Medical Center, Seoul, Republic of Korea
| | - Seung Jin Jung
- Department of Family Medicine, Sahmyook Medical Center, Seoul, Republic of Korea
| | - Yeongkeun Kwon
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yang Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Do Hoon Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youn Seon Choi
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Yong Gyu Park
- Department of Family Medicine, College of Medicine, The Catholic University of Korea Seoul, Seoul, Republic of Korea.
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Abstract
The purpose of this narrative review is to summarize evidence of the epidemiology of and risk factors for kidney cancer with a focus on renal cell carcinoma in adults. The etiology of kidney cancer is largely unknown and the main epidemiologic determinants are large geographic and temporal variations in incidence rates. Established risk factors include tobacco smoking, body size, and history of hypertension and chronic kidney disease. Other suspected risk factors require additional investigation, as do the underlying biologic mechanisms that are responsible for disease occurrence. Opportunities to prevent kidney cancer include targeting modifiable risk factors-for example, smoking abstinence/cessation and body weight control-as well as interventions along the diagnostic pathway to improve early diagnosis. Molecular epidemiology, including, but not limited to, metabolomics and tumor genomics, are new areas of research that promise to play important roles in identifying some of the underlying causes of kidney cancer.
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Affiliation(s)
- Ghislaine Scelo
- Ghislaine Scelo and Tricia L. Larose, International Agency for Research on Cancer, Lyon, France; and Tricia L. Larose, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tricia L. Larose
- Ghislaine Scelo and Tricia L. Larose, International Agency for Research on Cancer, Lyon, France; and Tricia L. Larose, Norwegian University of Science and Technology, Trondheim, Norway
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22
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Rao A, Wiggins C, Lauer RC. Survival outcomes for advanced kidney cancer patients in the era of targeted therapies. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:165. [PMID: 29911113 DOI: 10.21037/atm.2018.04.44] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Advanced renal cell carcinoma (RCC) results in over 14,000 deaths each year in the United States alone. The therapeutic landscape for advanced RCC changed dramatically with the approval of tyrosine kinase inhibitors (TKI) between 2006 and 2012. A large-scale analysis of survival trends has not been performed in the TKI era to determine their impact on outcomes for advanced RCC patients. Methods The Surveillance, Epidemiology and End-Results (SEER) database was queried for adult patients with advanced RCC diagnosed between 2000 and 2013. Patients were divided into two cohorts based on the year of diagnosis-pre-TKI cohort [2000-2006] and TKI cohort [2007-2013]. Kaplan-Meier survival and multivariate Cox proportional hazards analyses were performed. Results A total of 14,976 patients were included in our study. Median age at diagnosis was 64 years (range, 18-89 years). Median (cancer-specific) overall survival was 10.0 months in the TKI cohort compared with 8.0 months in the pre-TKI cohort, corresponding to a 13% improvement in survival in the TKI area [hazard ratio (HR) for death 0.87; 95% confidence interval (CI), 0.84-0.91, P<0.0001]. Median survival was improved by 2 months for patients with clear-cell RCC histology [HR for death 0.86; 95% CI, 0.84-0.91, P<0.0001]. Patients with non-clear cell RCC had a 25% higher risk of mortality compared with those with clear-cell RCC. Additionally, median survival for non-clear cell RCC patients was not statistically different between the two cohorts (HR for death 0.98; 95% CI, 0.88-1.09, P=0.714). Subgroup analysis showed that elderly patients (age 71 years and above) had a 45% higher risk of death from advanced RCC compared with young patients (aged 18-50 years) [HR for death 1.45; 95% CI, 1.36-1.54, P<0.0001]. Gender and racial disparities in outcomes were also noted with women having a 10% higher risk of death compared with men (HR for death 1.10; 95% CI, 1.06-1.14, P<0.001) and Black patients having a 15% higher risk of death compared with White patients (HR for death 1.15; 95% CI, 1.08-1.23, P<0.0001). Conclusions Our study provides a largest registry-based analysis of survival outcomes in the TKI era. In majority of patients, the survival has improved significantly with the advent of TKIs as standard of care therapy. Survival for patients with non-clear cell RCC is clearly worse than clear-cell RCC and does not appear to have changed with TKIs. Elderly patients, women, and Black patients appear to have worse outcomes and these disparities merit further investigation.
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Affiliation(s)
- Arpit Rao
- Division of Hematology, Oncology & Transplantation, University of Minnesota, Minnesota, MN, USA
| | - Charles Wiggins
- Department of Internal Medicine, New Mexico Tumor Registry, University of New Mexico, Albuquerque, NM, USA
| | - Richard C Lauer
- Division of Hematology and Oncology, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
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Tsujino T, Komura K, Ichihashi A, Tsutsumi T, Matsunaga T, Yoshikawa Y, Maenosono R, Okita K, Takai T, Oide R, Minami K, Uehara H, Taniguchi K, Hirano H, Nomi H, Ibuki N, Takahara K, Inamoto T, Azuma H. The combination of preoperative platelet count and neutrophil lymphocyte ratio as a prognostic indicator in localized renal cell carcinoma. Oncotarget 2017; 8:110311-110325. [PMID: 29299149 PMCID: PMC5746384 DOI: 10.18632/oncotarget.22688] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/28/2017] [Indexed: 01/06/2023] Open
Abstract
Introduction The combination of platelet count and neutrophil to lymphocyte ratio (COP-NLR) has been shown to provide prognostic information in several cancers, whereas its prognostic value in renal cell carcinoma (RCC) has not been reported. The objective of the present study was to examine the preoperative prognostic value of the COP-NLR in patients with localized RCC undergoing nephrectomy. Material and Methods The record of 268 patients, who underwent nephrectomy due to a diagnosis of RCC at our institute was analyzed in the study. The cut-off value of platelet count and NLR were defined by receive operating characteristic (ROC) analysis and the areas under the curve (AUC). Patients with both an increased platelet count (> 310×109/l) and an elevated NLR (> 3.85) were assigned to the score 2, and patients with one or neither of these indicators were assigned to the score 1 or 0, respectively. The impact of the COP-NLR and other clinicopathological characteristics on overall survival (OS) and recurrence-free survival (RFS) were evaluated using the univariate and multivariate Cox regression analysis. Result The median follow-up duration after surgical resection was 60 months. Multivariate analysis using the 10 clinicopathological findings selected by univariate analyses demonstrated that the preoperative COP-NLR was an independent prognostic factor for OS (HR: 2.32, 95%CI: 1.22 to 4.26, p=0.011) and RFS (HR: 1.91, 95%CI: 1.02 to 3.53, p=0.044). Conclusion The findings of the current study suggested that the preoperative COP-NLR is an independent prognostic indicator of OS and RFS for patients with localized RCC.
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Affiliation(s)
- Takuya Tsujino
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Kazumasa Komura
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan.,Translational Research Program, Osaka Medical College, Osaka 569-8686, Japan
| | | | - Takeshi Tsutsumi
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | | | - Yuki Yoshikawa
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | | | - Kyohei Okita
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Tomoaki Takai
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Rintaro Oide
- Department of Biological Fundamental Research, Osaka Medical College, Osaka 569-8686, Japan
| | - Koichiro Minami
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Hirofumi Uehara
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Kohei Taniguchi
- Translational Research Program, Osaka Medical College, Osaka 569-8686, Japan.,Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka 569-8686, Japan
| | - Hajime Hirano
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Hayahito Nomi
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Naokazu Ibuki
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Kiyoshi Takahara
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Teruo Inamoto
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
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The association between renal sinus fat area and the progression-free survival in Chinese non-metastatic clear-cell renal cell carcinoma patients. Oncotarget 2017; 8:65481-65491. [PMID: 29029447 PMCID: PMC5630347 DOI: 10.18632/oncotarget.19012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/19/2017] [Indexed: 11/28/2022] Open
Abstract
In this retrospective study, we evaluated the association between renal sinus fat area (RSFA) and survival in 268 Chinese non-metastatic clear-cell renal cell carcinoma (ccRCC) patients. Patients with high RSFA exhibited better progression-free survival than those with low RSFA in both univariable (HR: 0.240; 95% CI: 0.119–0.482; p < 0.001) and multivariable (HR: 0.432; 95% CI: 0.369–2.749; p = 0.027) analyses. A propensity-score matched (PSM) analysis using Kaplan-Meier curves confirmed our findings (log-rank test; p = 0.028). Based on the multivariable analysis, we constructed a prognostic nomogram with 4 factors, namely, RSFA, Fuhrman grade, AJCC stage and sarcomatoid component. The c-index values for the Leibovich scoring system and the nomogram were 0.762 (95%CI, 0.688–0.835) and 0.823 (95%CI, 0.759–0.888), respectively. These findings demonstrate that high RSFA is associated with better progression-free survival in non-metastatic ccRCC.
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25
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Renal cell carcinoma histological subtype distribution differs by age, gender, and tumor size in coastal Chinese patients. Oncotarget 2017; 8:71797-71804. [PMID: 29069747 PMCID: PMC5641090 DOI: 10.18632/oncotarget.17894] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/30/2017] [Indexed: 12/13/2022] Open
Abstract
The distribution pattern of renal cell carcinoma (RCC) histological subtypes according to age, gender and tumor size has not been well illustrated in RCC patients living in fast-developing regions of China. We recruited 2941 patients with clear cell renal cell carcinoma (ccRCC), papillary renal cell carcinoma (PCC) or chromophobe from two hospitals in coastal China (2004−2012) consecutively and draw 538 American Chinese RCC patients’ data with time matched from the Surveillance, Epidemiology, and End Results database. We found that compared with ccRCC patients, chromophobe patients were more likely to be female (OR: 2.538, 95% CI: 1.923−3.350), younger (OR for 51−60 years old: 0.686; OR for over 60 years old: 0.478; reference: age < 50) and to have a larger maximal diameter (Dmax) (OR for Dmax > 7 cm: 1.883; reference: Dmax ≤ 4 cm). Besides, in comparison with coastal Chinese patients, American Chinese individuals had lower Fuhrman grades (P < 0.001) and had an onset age 10 years delay. In conclusion, we were the first to observe marked gender, age and tumor size differences in the proportional subtype distribution of RCCs in coastal Chinese patients, and also the first to compare coastal Chinese with American Chinese data.
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26
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Paulucci DJ, Sfakianos JP, Skanderup AJ, Kan K, Tsao CK, Galsky MD, Hakimi AA, Badani KK. Genomic differences between black and white patients implicate a distinct immune response to papillary renal cell carcinoma. Oncotarget 2017; 8:5196-5205. [PMID: 28029648 PMCID: PMC5354901 DOI: 10.18632/oncotarget.14122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 11/22/2016] [Indexed: 12/25/2022] Open
Abstract
Significant disparities in survival, incidence and possibly response to current therapies exist between black and white patients with renal cell carcinoma (RCC). Recent genomic evidence to account for these disparities has been reported for clear cell RCC. However, racial disparities at the genomic level for papillary RCC (pRCC) which is a genetically distinct and less responsive histologic subtype of RCC have not been reported. Using The Cancer Genome Atlas (TCGA) data, the present study assessed gene-level expression, somatic mutation and pathway differences between 58 black and 58 white patients with pRCC propensity matched on age, gender and pathologic T stage. Distinct tumor biology with differential expression patterns were observed in black vs. white patients with pRCC. Specifically, significance analysis of microarrays was applied to TCGA gene expression data and identified 163 genes and 120 genes overexpressed in black and white patients, respectively (FDR q<0.05). Gene Set Enrichment Analysis identified 62 gene sets enriched (p<0.10) in blacks. Enrichment of immune immune system pathways were noted in black patients. These included the B cell receptor signaling pathway, the NOD-like receptor signaling pathway and genes involved in defensins. The VEGF pathway was also more significant in black patients. CRYBB2, a gene associated with the WNT pathway was overexpressed in Black patients. While our data requires validation, these findings suggest that race may have implications for distinct immune responses to cancer and that the use of immunotherapies, and VEGFR inhibitors to target these pathways may improve survival in black patients with advanced pRCC.
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Affiliation(s)
- David J. Paulucci
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - John P. Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Anders J. Skanderup
- Computational Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathleen Kan
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Che-Kai Tsao
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew D. Galsky
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A. Ari Hakimi
- Department of Surgery—Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ketan K. Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
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27
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Racial Disparities in Histology and Short-Term Renal Functional Outcomes Following Robotic Nephron-Sparing Surgery. Clin Genitourin Cancer 2016; 15:203-206. [PMID: 27554583 DOI: 10.1016/j.clgc.2016.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/14/2016] [Accepted: 07/17/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE To identify variations in renal function and histology between Caucasian Americans (CA) and African Americans (AA) undergoing robotic nephron-sparing surgery (NSS). METHODS A retrospective chart review was performed on patients who underwent NSS. Multivariate analysis identified factors affecting postoperative estimated glomerular filtration rate (eGFR). Histology was re-reviewed by pathology to confirm papillary type. RESULTS A total of 331 patients underwent NSS: CA (n = 212), AA (n = 105), Hispanic (n = 10), and other (n = 4). AA average age (60.1 years) was lower than CA (62.3 years) (P < .001), with a higher proportion of AA women (46%) than CA (37%) (P = .021). AA had a higher incidence of diabetes (58.2%) and hypertension (93.9%). Preoperative average eGFR was similar: 70.35 mL/min for AA versus 69.06 mL/min for CA. Average postoperative eGFR was 50.59 mL/min for AA and 57.85 mL/min for CA. Postoperative creatinine increased more in AA (0.44 mg/dL) versus CA (0.33 mg/dL) (P < .001) even when stratified by pathological stage. Clear cell renal cell carcinoma (RCC) was the most common histology with AA (45%) and CA (60%). A greater than 2-fold higher incidence of papillary RCC was observed in AA (31%) versus CA (13%). AA exhibited a greater proportion of high-grade or type 2 papillary RCC (40% and 30%) versus CA (25% and 13%). CONCLUSIONS AA patients were treated at a younger age, with a larger proportion of women. Postoperatively, AA experienced a greater increase in serum creatinine. Final histology demonstrated greater papillary RCC incidence in AA and increased likelihood for type 2 papillary RCC, a more aggressive histology.
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Hu H, Yao X, Xie X, Wu X, Zheng C, Xia W, Ma S. Prognostic value of preoperative NLR, dNLR, PLR and CRP in surgical renal cell carcinoma patients. World J Urol 2016; 35:261-270. [PMID: 27255479 DOI: 10.1007/s00345-016-1864-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 05/23/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Emerging evidences indicate that inflammation plays a crucial role in carcinogenesis and tumor progression. Inflammatory response biomarkers are recognized as promising prognostic factors for improving predictive accuracy in renal cell carcinoma (RCC). We aimed to evaluate the prognostic significance of preoperative neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR) and serum C-reactive protein (CRP) in RCC. METHODS 484 surgical RCC patients were enrolled from 2006 to 2010 in this study. Receiver operating curve (ROC) was applied to assess the optimal cutoff levels for four biomarkers, and the prognostic values were determined by Kaplan-Meier curve, univariate and multivariate COX regression models. The predictive accuracy was evaluated by concordance index (c-index). RESULTS The median follow-up duration after surgical resection was 36 months. The optimal cutoff levels were 2.78 for NLR, 2.05 for dNLR, 185 for PLR and 5.1 for CRP by ROC curves analysis. Elevated NLR, dNLR, PLR and CRP were significantly correlated with worse overall survival (OS). Multivariate analysis showed that elevated NLR was an independent risk factor for OS, and NLR was superior to dNLR, PLR and CRP based on hazard ratio (HR 2.10, 95 % CI 1.21-3.64, P = 0.008). Additionally, the nomogram could more effectively work in predicting OS (c-index: 0.749) in surgical RCC patients. CONCLUSION Pre-operation NLR can be considered as a potential prognostic biomarker in patients with RCC who underwent surgical resection.
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Affiliation(s)
- Hong Hu
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, 214400, Jiangsu, China
| | - Xiajuan Yao
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, 214400, Jiangsu, China
| | - Xiangcheng Xie
- Department of Nephrology, Hangzhou First People's Hospital, Hangzhou Hospital Affiliated to Nanjing Medical University, Hangzhou, Zhejiang, China
| | - Xia Wu
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, 214400, Jiangsu, China
| | - Chuanming Zheng
- Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhengjiang, China
| | - Wenkai Xia
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, 214400, Jiangsu, China.
| | - Shenglin Ma
- Department of Oncology, Hangzhou First People's Hospital, Hangzhou Hospital Affiliated to Nanjing Medical University, 261 Huansha Road, Hangzhou, 310006, Zhejiang, China.
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29
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Paulucci DJ, Sfakianos JP, Yadav SS, Badani KK. BAP1 is overexpressed in black compared with white patients with Mx-M1 clear cell renal cell carcinoma: A report from the cancer genome atlas. Urol Oncol 2016; 34:259.e9-259.e14. [DOI: 10.1016/j.urolonc.2015.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/15/2015] [Accepted: 12/30/2015] [Indexed: 12/17/2022]
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30
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Harris WB. Biomarkers for evaluating racial disparities in clinical outcome in patients with renal cell carcinoma. Mol Aspects Med 2015; 45:47-54. [DOI: 10.1016/j.mam.2015.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/06/2015] [Indexed: 12/25/2022]
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31
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Shen T, Shu XO, Xiang YB, Li HL, Cai H, Gao YT, Zheng W, Lipworth L. Association of hypertension and obesity with renal cell carcinoma risk: a report from the Shanghai Men's and Women's Health Studies. Cancer Causes Control 2015; 26:1173-80. [PMID: 26081424 DOI: 10.1007/s10552-015-0611-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 06/02/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Consistently reported associations between hypertension and obesity and renal cell carcinoma (RCC) risk have largely come from studies in Western populations. These associations were examined in a case-control study nested in the Shanghai Women's Health Study (SWHS, 1996-2000) and Shanghai Men's Health Study (SMHS, 2001-2006). METHODS Overall, 271 incident RCC cases (124 women, 147 men) were identified through 31 December 2011, and 2,693 controls were individually matched by sex, age, and calendar time at cohort enrollment, and menopausal status (for women). Participants completed a structured questionnaire by in-person interview at baseline, and conditional logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS Self-reported hypertension was associated with a significant 40 % increased risk of RCC among women and men (95 % CI 1.1, 1.9). Body mass index (BMI), modeled continuously, was associated with an elevated risk of RCC among men, with an OR of 1.5 (95 % CI 1.1, 2.0) per 5 kg/m(2) increase in BMI, but not among women. CONCLUSIONS Hypertension is independently associated with risk of RCC among both women and men in Shanghai, while overweight and obesity appear to be associated with risk of RCC in Chinese men only.
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Affiliation(s)
- Tian Shen
- Division of Epidemiology, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 800, Nashville, TN, 37203-1738, USA
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Lipworth L, Morgans AK, Edwards TL, Barocas DA, Chang SS, Herrell SD, Penson DF, Resnick MJ, Smith JA, Clark PE. Renal cell cancer histological subtype distribution differs by race and sex. BJU Int 2015; 117:260-5. [PMID: 25307281 DOI: 10.1111/bju.12950] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To examine racial differences in the distribution of histological subtypes of renal cell carcinoma (RCC) and associations with established RCC risk factors by subtype. MATERIALS AND METHODS Tumours from 1532 consecutive patients with RCC who underwent nephrectomy at Vanderbilt University Medical Center (1998-2012) were classified as clear-cell, papillary, chromophobe and other subtypes. In pairwise comparisons, we used multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between race, sex, age, end-stage renal disease (ESRD) and body mass index at diagnosis according to histological subtype. RESULTS The RCC subtype distribution was significantly different in black people from that in white people (P < 0.001), with a substantially higher proportion of patients with papillary RCC among black people than white people (35.7 vs 13.8%). In multivariate analyses, compared with clear-cell RCC, people with papillary RCC were significantly more likely to be black (OR 4.15; 95% CI 2.64-6.52) and less likely to be female (OR 0.60; 95% CI 0.43-0.83). People with chromophobe RCC were significantly more likely to be female (OR 2.32; 95% CI 1.44-3.74). Both people with papillary RCC (OR 6.26; 95% CI 2.75-14.24) and those with chromophobe RCC (OR 7.07; 95% CI 2.13-23.46) were strongly and significantly more likely to have ESRD, compared with those with clear-cell RCC. CONCLUSION We observed marked racial differences in the proportional subtype distribution of RCCs diagnosed at a large tertiary care academic centre. To our knowledge, no previous study has examined racial differences in the distribution of RCC histologies while adjusting for ESRD, which was the factor most strongly associated with papillary and chromophobe RCC compared with clear-cell RCC.
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Affiliation(s)
- Loren Lipworth
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alicia K Morgans
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Todd L Edwards
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel A Barocas
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sam S Chang
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - S Duke Herrell
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David F Penson
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew J Resnick
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joseph A Smith
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peter E Clark
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Xiao Q, Liao L, Matthews CE, Chow WH, Davis F, Schwartz K, Purdue M, Hofmann JN, Colt J. Physical activity and renal cell carcinoma among black and white Americans: a case-control study. BMC Cancer 2014; 14:707. [PMID: 25253394 PMCID: PMC4181698 DOI: 10.1186/1471-2407-14-707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 09/16/2014] [Indexed: 01/20/2023] Open
Abstract
Background Renal cell carcinoma (RCC) has a higher incidence in blacks than in whites. Physical activity may influence the risk of renal cell cancer, but the evidence is inconsistent. No previous study has investigated this relationship in the black population. Methods We examined the association between self-reported physical activity at different ages and risk of RCC in a population based case-control study of 1217 cases (361 black, 856 white) and 1235 controls (523 black, 712 white) frequency-matched on age, race, and gender. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression. Results Among whites, increased risks of RCC were observed among participants reporting low levels of transportation-related activity in their 20’s (OR <1 hr/wk vs >7 hr/wk (95% CI): 1.42 (1.10, 1.83)) and leisure time activity in their 50’s (OR <1 hr/wk vs >7 hr/wk (95% CI): 1.49 (1.00, 2.20)). We found no association between physical activity and RCC risk among blacks. Conclusion Our results suggest that physical activity may be inversely associated with RCC risk in whites, but there was no evidence of such an association in blacks. As this is the first study evaluating the effect of physical activity on RCC risk among blacks, further investigations are needed to clarify the relationship in this population. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-707) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Qian Xiao
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Ailawadhi S, Swaika A, Razavi P, Yang D, Chanan-Khan A. Variable risk of second primary malignancy in multiple myeloma patients of different ethnic subgroups. Blood Cancer J 2014; 4:e243. [PMID: 25192415 PMCID: PMC4183772 DOI: 10.1038/bcj.2014.63] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/10/2014] [Accepted: 07/24/2014] [Indexed: 12/31/2022] Open
Abstract
Second primary malignancies (SPMs) among multiple myeloma (MM) patients have been reported with an estimated incidence varying from 1 to 15%. We have previously reported that significant disparity exists in MM survival across patients of different ethnicities. We undertook a Surveillance Epidemiology and End Results-based analysis to describe the incidence of SPMs among MM patients of different ethnicities, to explore the variable impact that SPMs might have on MM outcomes of patients across racial subgroups. We found that the risk of developing SPMs among MM patients is variable depending on the patient's ethnic background. This warrants further exploration of the impact of SPMs on outcomes of MM patients across different racial subgroups, especially in the form of prospective data collection and analyses.
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Affiliation(s)
- S Ailawadhi
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - A Swaika
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - P Razavi
- Division of Hematology/Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Yang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Chanan-Khan
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
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Danzig MR, Weinberg AC, Ghandour RA, Kotamarti S, McKiernan JM, Badani KK. The Association Between Socioeconomic Status, Renal Cancer Presentation, and Survival in the United States: A Survival, Epidemiology, and End Results Analysis. Urology 2014; 84:583-9. [DOI: 10.1016/j.urology.2014.05.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 05/15/2014] [Accepted: 05/23/2014] [Indexed: 01/26/2023]
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36
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Clinicopathological characteristics and outcomes of surgically excised renal masses in African Americans. Urol Oncol 2014; 32:555-60. [DOI: 10.1016/j.urolonc.2013.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/21/2013] [Accepted: 11/21/2013] [Indexed: 11/21/2022]
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37
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Kates M, Whalen MJ, Badalato GM, McKiernan JM. The effect of race and gender on the surgical management of the small renal mass. Urol Oncol 2013; 31:1794-9. [DOI: 10.1016/j.urolonc.2012.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/09/2012] [Accepted: 05/09/2012] [Indexed: 01/13/2023]
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38
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Shea MW. A proposal for a targeted screening program for renal cancer. Front Oncol 2013; 3:207. [PMID: 23971005 PMCID: PMC3747444 DOI: 10.3389/fonc.2013.00207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 07/30/2013] [Indexed: 01/09/2023] Open
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Olshan AF, Kuo TM, Meyer AM, Nielsen ME, Purdue MP, Rathmell WK. Racial difference in histologic subtype of renal cell carcinoma. Cancer Med 2013; 2:744-9. [PMID: 24403240 PMCID: PMC3892806 DOI: 10.1002/cam4.110] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/20/2013] [Accepted: 06/12/2013] [Indexed: 12/21/2022] Open
Abstract
In the United States, renal cell carcinoma (RCC) has rapidly increased in incidence for over two decades. The most common histologic subtypes of RCC, clear cell, papillary, and chromophobe have distinct genetic and clinical characteristics; however, epidemiologic features of these subtypes have not been well characterized, particularly regarding any associations between race, disease subtypes, and recent incidence trends. Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we examined differences in the age-adjusted incidence rates and trends of RCC subtypes, including analysis focusing on racial differences. Incidence rates increased over time (2001-2009) for all three subtypes. However, the proportion of white cases with clear cell histology was higher than among blacks (50% vs. 31%, respectively), whereas black cases were more likely than white cases to have papillary RCC (23% vs. 9%, respectively). Moreover, papillary RCC incidence increased more rapidly for blacks than whites (P < 0.01) over this period. We also observed that increased incidence of papillary histology among blacks is not limited to the smallest size strata. We observed racial differences in proportionate incidence of RCC subtypes, which appear to be increasing over time; this novel finding motivates further etiologic, clinical, molecular, and genetic studies.
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Affiliation(s)
- Andrew F Olshan
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
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40
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Incidence and prognostic significance of second primary cancers in renal cell carcinoma. Am J Clin Oncol 2013; 36:132-42. [PMID: 22441339 DOI: 10.1097/coc.0b013e3182438ddf] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The survival of patients with renal cell carcinoma (RCC) has improved in recent years. However, data on the risk of developing a second cancer after a diagnosis of RCC is limited. We used the data available in the Surveillance Epidemiology and End Results (SEER) database to estimate the risk of second metachronous primary cancers in patients diagnosed with RCC between 1973 and 2006. Furthermore, we also investigated the effect of the second primary cancers (SPCs) on the survival of RCC patients. RESULTS A total of 3795 cases of SPCs were registered in the SEER between 1973 and 2006. The ratio of observed/expected number of SPCs in RCC was 1.18, which was significantly greater than expected. Solid tumors comprised 90% of all second malignancies in RCC patients, with the most second cancers reported in the prostate gland and the digestive and respiratory systems. The overall risk of second primaries was highest in patients aged over 30 years at the time of diagnosis. The site-specific risk of second cancers varied with the age at diagnosis, sex, race of the patient, size of the primary renal tumor, and history of radiation therapy. Patients with second primaries had a significantly longer overall survival than those without second malignancies. An interval of <1 year between the diagnosis of RCC and the second primary was the strongest predictor of poor overall survival in RCC patients with a second malignancy. CONCLUSIONS Patients with RCC are at a significantly higher risk of developing a second malignancy, suggesting the need for careful surveillance for their early detection and management.
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Ylitalo AW, Ylitalo KR, Santucci RA. Lack of genitourinary physical examination before urologic consultation--a quality of care issue. Urology 2013. [PMID: 23206768 DOI: 10.1016/j.urology.2012.07.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To quantify the frequency of genitourinary (GU) physical examinations obtained by the emergency department or primary hospital team before obtaining a urologic consultation and evaluate the role of the different demographic and clinical factors. MATERIALS AND METHODS For 6 weeks, from July to August 2010, 420 consecutive patients evaluated by the urology consultation service had their medical charts reviewed retrospectively, with the frequency of GU physical examination performed by the emergency department or primary hospital team recorded. RESULTS Of 357 patients requiring a urologic consultation, 88 of 324 (27%) had a GU physical examination performed by the emergency department and 98 of 319 (31%) had a GU physical examination performed by the primary hospital team before the urologic consultation. The emergency department was 6 times more likely to perform a GU physical examination on a male patient than a female patient, and the primary team was twice as likely to perform a GU physical examination on a male patient than a female patient. The likelihood of examination by either team decreased as patients became older. Race was not significantly associated with the likelihood of examination. CONCLUSION The results of our study indicate that examinations are performed less than one-third of the time before obtaining a urologic consultation, with the frequency related to age and sex. The low rate of preconsultation examination creates concern for quality of care, the correctness of billing, and unnecessary urologic consultations.
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Hall EC, Segev DL, Engels EA. Racial/ethnic differences in cancer risk after kidney transplantation. Am J Transplant 2013; 13:714-20. [PMID: 23331953 PMCID: PMC4241757 DOI: 10.1111/ajt.12066] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 10/29/2012] [Accepted: 11/19/2012] [Indexed: 01/25/2023]
Abstract
Transplant recipients have elevated cancer risk, but it is unknown if cancer risk differs across race and ethnicity as in the general population. US kidney recipients (N = 87,895) in the Transplant Cancer Match Study between 1992 and 2008 were evaluated for racial/ethnic differences in risk for six common cancers after transplantation. Compared to white recipients, black recipients had lower incidence of non-Hodgkin lymphoma (NHL) (adjusted incidence rate ratio [aIRR] 0.60, p<0.001) and higher incidence of kidney (aIRR 2.09, p<0.001) and prostate cancer (aIRR 2.14, p<0.001); Hispanic recipients had lower incidence of NHL (aIRR 0.64, p = 0.001), lung (aIRR 0.41, p < 0.001), breast (aIRR 0.53, p = 0.003) and prostate cancer (aIRR 0.72, p = 0.05). Colorectal cancer incidence was similar across groups. Standardized incidence ratios (SIRs) measured the effect of transplantation on cancer risk and were similar for most cancers (p≥0.1). However, black and Hispanic recipients had larger increases in kidney cancer risk with transplantation (SIRs: 8.96 in blacks, 5.95 in Hispanics vs. 4.44 in whites), and only blacks had elevated prostate cancer risk following transplantation (SIR: 1.21). Racial/ethnic differences in cancer risk after transplantation mirror general population patterns, except for kidney and prostate cancers where differences reflect the effects of end-stage renal disease or transplantation.
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Affiliation(s)
- E C Hall
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
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Shu X, Lin J, Wood CG, Tannir NM, Wu X. Energy balance, polymorphisms in the mTOR pathway, and renal cell carcinoma risk. J Natl Cancer Inst 2013; 105:424-32. [PMID: 23378641 DOI: 10.1093/jnci/djt005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The interplay between obesity, physical activity, weight gain, and genetic variants in the mTOR pathway has not been studied in renal cell carcinoma (RCC). We examined the associations between obesity, weight gain, physical activity, and RCC risk. We also analyzed whether genetic variants in the mTOR pathway could modify the association. METHODS Incident RCC case subjects and healthy control subjects were recruited from the University of Texas MD Anderson Cancer Center in Houston, Texas. Case subjects and control subjects were frequency matched. Epidemiologic data were collected by in-person interview. One hundred ninety single nucleotide polymorphisms (SNPs) from 22 genes in the mTOR pathway were extracted from previous genome-wide association studies. Logistic regression and regression spline were performed to obtain odds ratios (ORs). All statistical tests were two-sided. RESULTS A total of 577 non-Hispanic white case subjects and 593 healthy control subjects were included. Obesity at age 20 years (OR = 1.92, 95% confidence interval [CI] = 1.05 to 3.50; P = .03) and age 40 years (OR = 2.03, 95% CI = 1.38 to 2.98; P < .001) and moderate (OR = 1.46, 95% CI = 1.02 to 2.09; P = .04) and massive weight gain (OR = 1.62, 95% CI = 1.10 to 2.39; P = .01) from age 20 to 40 years were each statistically significantly associated with increased RCC risk. Low physical activity was associated with a 4.08-fold increased risk. Among 190 SNPs in the mTOR pathway, six SNPs located in the AKT3 gene were statistically significantly associated with increased risk, and those with three or more unfavorable genotypes had a 1.72-fold increased risk of RCC. CONCLUSION Obesity, weight gain, physical activity, and genetic variants in the mTOR pathway may individually and jointly influence susceptibility to RCC.
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Affiliation(s)
- Xiang Shu
- Department of Epidemiology, Unit 1340, University of Texas MD Anderson Cancer Center, 1155 Pressler Blvd, Houston, TX 77030, USA
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Hofmann JN, Schwartz K, Chow WH, Ruterbusch JJ, Shuch BM, Karami S, Rothman N, Wacholder S, Graubard BI, Colt JS, Purdue MP. The association between chronic renal failure and renal cell carcinoma may differ between black and white Americans. Cancer Causes Control 2013; 24:167-74. [PMID: 23179659 PMCID: PMC3531044 DOI: 10.1007/s10552-012-0102-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 11/07/2012] [Indexed: 02/06/2023]
Abstract
PURPOSE In the United States, renal cell carcinoma (RCC) incidence is higher among blacks than among whites. Risk of RCC is elevated among end-stage renal disease patients, although no studies have looked at differences by race in the relationship between chronic renal failure and RCC. METHODS We investigated RCC risk in relation to chronic renal failure in a population-based case-control study of blacks and whites in Chicago and Detroit. Data, including information on kidney disease, were collected from interviews with 1,217 RCC cases (361 blacks, 856 whites) and 1,235 controls (523 blacks, 712 whites). Odds ratios (OR) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression. RESULTS Risk of RCC was increased in relation to chronic renal failure (OR 4.7, 95 % CI 2.2-10.1) and dialysis (OR 18.0, 95 % CI 3.6-91). The association remained after defining exposure as those who had chronic renal failure ≥10 years prior to RCC diagnosis. Chronic renal failure was more strongly associated with RCC among blacks than among whites (OR 8.7, 95 % CI 3.3-22.9 and 2.0, 0.7-5.6, respectively; p (interaction) = 0.03) and among those without a history of diabetes relative to diabetic subjects (OR 8.3, 95 % CI 3.1-22.7 and 1.9, 0.6-5.9, respectively; p (interaction) = 0.03). CONCLUSIONS These results suggest that chronic renal failure is a strong risk factor for RCC, particularly among black and non-diabetic subjects. Our findings of differences in risk estimates by race, to our knowledge the first such report, require replication.
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Affiliation(s)
- Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892-7240, USA.
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Population based analysis of the increasing incidence of kidney cancer in the United States: evaluation of age specific trends from 1975 to 2006. J Urol 2011; 187:32-8. [PMID: 22088338 DOI: 10.1016/j.juro.2011.09.028] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Indexed: 12/16/2022]
Abstract
PURPOSE An increase in kidney cancer was reported in the United States but overall rates may obscure trends in age specific groups. We explored whether the increase in kidney cancer incidence differs across age groups. MATERIALS AND METHODS We ascertained the 63,843 incident renal cancer cases in SEER (Surveillance, Epidemiology and End Results) cancer registries for 1975 to 2006. Yearly incidence rates of renal cancer were calculated and stratified by age group. Age specific trends in cancer diagnosis were evaluated by Poisson regression. RESULTS From 1975 to 2006 the overall age adjusted renal cancer incidence increased 238% from 7.4/100,000 to 17.6/100,000 adults. From 1991 to 2006 the mean age at diagnosis decreased from 64.7 to 62.7 years and the proportion of patients diagnosed before age 65 years increased from 45.9% to 55.3%. Age specific incidence rates of renal cancer increased in all age groups from 1975 to 2006 (p <0.0001). However, the rates changed at different rates. Overall renal cancer diagnosis in the youngest age group (20 to 39 years) increased more quickly than all other age groups (p <0.0001). The renal cancer incidence in patients 60 to 69 and 70 to 79 years old increased more rapidly than in those 40 to 49 and 50 to 59 years old (p <0.01). CONCLUSIONS In the last 15 years mean age at diagnosis of renal cancer has decreased. During our study period the most rapidly increasing kidney cancer incidence was seen in those younger than 40 and 60 to 79 years old. The renal cancer increase in younger patients should direct attention toward further evaluation of renal cancer risk factors.
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Moyad MA. Heart health = urologic health and heart unhealthy = urologic unhealthy: rapid review of lifestyle changes and dietary supplements. Urol Clin North Am 2011; 38:359-67. [PMID: 21798398 DOI: 10.1016/j.ucl.2011.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease.
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Affiliation(s)
- Mark A Moyad
- Department of Urology, University of Michigan Medical Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0330, USA.
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