1
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Zhao L, Liu W, Chu L, Luo L. Factors associated with survival in paediatric and adolescent renal cell carcinoma: a population-based study. ANZ J Surg 2023; 93:2710-2715. [PMID: 37458221 DOI: 10.1111/ans.18614] [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: 01/27/2023] [Revised: 05/12/2023] [Accepted: 07/06/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The purpose of this study was to conduct a population-based study to determine the prognosis of renal cell carcinoma (RCC) in children and adolescents. METHODS Patients with RCC who were registered in the Surveillance, Epidemiology, and End Results (SEER) program between 2000 and 2018 had their demographic and clinical characteristics evaluated retrospectively. The log-rank test was used to compare survival curves. Kaplan-Meier estimates were used to generate survival curves based on various factors. To identify factors associated with overall survival, Cox proportional-hazards regression was used. RESULTS A total of 251 patients were enrolled in the study. For all patients, the overall survival (OS) rates at 3- and 5- year were 93.5% and 92.0%, respectively. A multivariable study revealed that the following factors were independently associated with overall survival: sex, race, histologic type, SEER stage, AJCC stage, and type of surgery. Cox analysis showed that white patients had the lowest risk of mortality (hazard ratio (HR) 2.58, 95% confidence interval (CI), 1.33-4.99; P = 0.005), compared with black patients. Patients having metastatic disease had significantly higher mortality risk (HR 43, 95% CI, 14.8-125; P < 0.001) than the patients with localized tumour. CONCLUSIONS Our study emphasizes the importance of race, SEER stage, and surgery in the prognosis of paediatric RCC, providing valuable epidemiological evidence for clinical practice. Economic studies assessing a race/ethnic group specific strategy are also required.
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Affiliation(s)
- Lingling Zhao
- Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Wenyuan Liu
- Department of Pediatrics, The Second Hospital of Anhui Medical University, Hefei, China
| | - Likai Chu
- Department of Ultrasound, Children's Hospital of Soochow University, Suzhou, China
| | - Laiyue Luo
- Department of Nephrology, Anji Branch of the First Affiliated Hospital of Zhejiang University, Anji County People's Hospital, Huzhou, China
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2
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Alshehri RA, Alaqeel S, AlOtaiby SH, Aldraihem A. Cystic Renal Cell Carcinoma Subtype in Pediatric Patient: A Case Report. Cureus 2022; 14:e28331. [PMID: 36168386 PMCID: PMC9500468 DOI: 10.7759/cureus.28331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 11/05/2022] Open
Abstract
A 10-year-old boy presented with a right flank mass. Computed tomography, ultrasound scan, and magnetic resonance imaging confirmed the presence of a multiloculated cystic mass. After right kidney nephrectomy, the biopsy proved the diagnosis of cystic renal cell carcinoma, which is a rare subtype of renal cell carcinoma in the pediatrics age group. The knowledge about this incidence can optimize the investigations, management, and outcomes.
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3
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van der Beek JN, Hol JA, Coulomb‐l'Hermine A, Graf N, van Tinteren H, Pritchard‐Jones K, Houwing ME, de Krijger RR, Vujanic GM, Dzhuma K, Schenk J, Littooij AS, Ramírez‐Villar GL, Murphy D, Ray S, Al‐Saadi R, Gessler M, Godzinski J, Ruebe C, Collini P, Verschuur AC, Frisk T, Vokuhl C, Hulsbergen‐van de Kaa CA, de Camargo B, Sandstedt B, Selle B, Tytgat GAM, van den Heuvel‐Eibrink MM. Characteristics and outcome of pediatric renal cell carcinoma patients registered in the International Society of Pediatric Oncology (SIOP) 93-01, 2001 and UK-IMPORT database: A report of the SIOP-Renal Tumor Study Group. Int J Cancer 2021; 148:2724-2735. [PMID: 33460450 PMCID: PMC8048605 DOI: 10.1002/ijc.33476] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 01/16/2023]
Abstract
In children, renal cell carcinoma (RCC) is rare. This study is the first report of pediatric patients with RCC registered by the International Society of Pediatric Oncology-Renal Tumor Study Group (SIOP-RTSG). Pediatric patients with histologically confirmed RCC, registered in SIOP 93-01, 2001 and UK-IMPORT databases, were included. Event-free survival (EFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Between 1993 and 2019, 122 pediatric patients with RCC were registered. Available detailed data (n = 111) revealed 56 localized, 30 regionally advanced, 25 metastatic and no bilateral cases. Histological classification according to World Health Organization 2004, including immunohistochemical and molecular testing for transcription factor E3 (TFE3) and/or EB (TFEB) translocation, was available for 65/122 patients. In this group, the most common histological subtypes were translocation type RCC (MiT-RCC) (36/64, 56.3%), papillary type (19/64, 29.7%) and clear cell type (4/64, 6.3%). One histological subtype was not reported. In the remaining 57 patients, translocation testing could not be performed, or TFE-cytogenetics and/or immunohistochemistry results were missing. In this group, the most common RCC histological subtypes were papillary type (21/47, 44.7%) and clear cell type (11/47, 23.4%). Ten histological subtypes were not reported. Estimated 5-year (5y) EFS and 5y OS of the total group was 70.5% (95% CI = 61.7%-80.6%) and 84.5% (95% CI = 77.5%-92.2%), respectively. Estimated 5y OS for localized, regionally advanced, and metastatic disease was 96.8%, 92.3%, and 45.6%, respectively. In conclusion, the registered pediatric patients with RCC showed a reasonable outcome. Survival was substantially lower for patients with metastatic disease. This descriptive study stresses the importance of full, prospective registration including TFE-testing.
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Affiliation(s)
- Justine N. van der Beek
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Department of Radiology and Nuclear MedicineUniversity Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht UniversityUtrechtThe Netherlands
| | - Janna A. Hol
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | | | - Norbert Graf
- Department of Pediatric Oncology and HematologySaarland University Medical Center and Saarland University Faculty of MedicineHomburgGermany
| | | | | | - Maite E. Houwing
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Department of PathologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Kristina Dzhuma
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Jens‐Peter Schenk
- Clinic of Diagnostic and Interventional Radiology, Division of Pediatric RadiologyHeidelberg University HospitalHeidelbergGermany
| | - Annemieke S. Littooij
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Department of Radiology and Nuclear MedicineUniversity Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht UniversityUtrechtThe Netherlands
| | | | - Dermot Murphy
- Department of Paediatric OncologyRoyal Hospital for ChildrenGlasgowScotland
| | - Satyajit Ray
- Department of Paediatric OncologyRoyal Hospital for ChildrenGlasgowScotland
| | - Reem Al‐Saadi
- UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
- Department of HistopathologyGreat Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - Manfred Gessler
- Theodor‐Boveri‐Institute/BiocenterUniversity of WuerzburgWuerzburgGermany
| | - Jan Godzinski
- Department of Paediatric SurgeryMarciniak HospitalWroclawPoland
- Department of Paediatric Traumatology and Emergency MedicineMarciniak HospitalWroclawPoland
| | - Christian Ruebe
- Department of Radiation OncologySaarland University Medical Center and Saarland University Faculty of MedicineHomburgGermany
| | - Paola Collini
- Department of PathologyFondazione IRCCS Istituto Nazionale dei TumoriMilanoItaly
| | - Arnaud C. Verschuur
- Department of Pediatric OncologyHôpital d'Enfants de la TimoneMarseilleFrance
| | - Tony Frisk
- Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Christian Vokuhl
- Section of Pediatric PathologyUniversity Hospital BonnBonnGermany
| | | | | | - Bengt Sandstedt
- Childhood Cancer Research UnitAstrid Lindgren's Children's Hospital, Karolinska InstitutetStockholmSweden
| | - Barbara Selle
- Department of Pediatric Hematology and OncologySt. Annastift Children's HospitalLudwigshafenGermany
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4
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He M, Cai J, Zhu K, Gu W, Li M, Xiong J, Guan Z, Wang J, Shu Q. Renal cell carcinoma in children and adolescents: Single-center experience and literature review. Medicine (Baltimore) 2021; 100:e23717. [PMID: 33466124 PMCID: PMC7808530 DOI: 10.1097/md.0000000000023717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 11/16/2020] [Indexed: 01/05/2023] Open
Abstract
Renal cell carcinoma (RCC) is infrequent in the pediatric population. In addition, till date, only a few reports have summarized the characteristics of pediatric RCC and differences between pediatric and adult RCC. Therefore, the current study aimed to investigate the clinical characteristics of RCC in children and adolescents, and identify the differences between children and adolescent patients and adult patients through literature retrieval.The data of 13 pediatric patients diagnosed with RCC at the Children's Hospital of Zhejiang University School of Medicine between 2005 and 2019 were retrospectively analyzed.Three patients were aged <5 years, 2 were aged 6 to 10 years, and 8 were aged 11 to 18 years. Among the 13 patients, common clinical manifestations included abdominal pain in 5 patients, gross hematuria in 4, and an abdominal mass in 1, while the other 3 patients were incidentally detected after an abdominal contusion. The pathological types were microphthalmia family translocation RCC in 9 patients, clear-cell RCC in 2, papillary RCC in 1, and unclassified in 1. All the children underwent radical nephrectomy, including 2 patients with advanced disease who underwent preoperative transcatheter arterial chemoembolization. The mean follow-up time was 58.6 months. Two patients died after 4 and 17 months of follow-up, respectively.In conclusion, microphthalmia family translocation renal cell carcinoma is the predominant type of pediatric RCC associated with advanced tumor stage. The early diagnosis and treatment of pediatric patients is important for improving prognosis. Nevertheless, future studies are urgently needed to determine the treatment for pediatric advanced RCC to increase the survival rate.
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Affiliation(s)
- Min He
- Department of Surgical Oncology
| | | | - Kun Zhu
- Department of Pathology, The Children's Hospital, Zhejiang University School Of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Weizhong Gu
- Department of Pathology, The Children's Hospital, Zhejiang University School Of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
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5
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Mahajan A, Adiga P, Pai V, Raj K. Paediatric RCC with sarcomatoid variation: a rare entity. AFRICAN JOURNAL OF UROLOGY 2020. [DOI: 10.1186/s12301-020-00101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Malignant renal masses in paediatric age group are mostly Wilms’ tumour. RCC is very rare in this age group, papillary variant being the most common. Sarcomatoid variation occurs in 5% of adult RCC, while it is extremely rare in children. No treatment protocol exists in the management of paediatric RCC.
Case presentation
Here, we present a case of 10-year-old female who presented with left flank mass. Radical nephrectomy was done which showed clear cell carcinoma with sarcomatoid variant on histopathological examination.
Conclusion
RCC with sarcomatoid variation can occur in children. However, further studies and long-term follow-up are needed for formulating a treatment protocol and prognostication factors for the same.
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6
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Yahaya JJ, Bartholomew N, Mremi A. Metastatic Papillary Renal Cell Carcinoma in a 13-Year Old Girl: A Case Report and Review of the Literature Mainly Focusing on Treatment and Prognosis. Int J Surg Case Rep 2020; 77:791-794. [PMID: 33395897 PMCID: PMC7718312 DOI: 10.1016/j.ijscr.2020.11.116] [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] [Received: 10/27/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Renal cell carcinoma (RCC) accounts for less than 0.3% of all tumours occurring in children and adolescents and it also affects 2.6% of all renal tumours for the pediatriac population. The aim of this report is to present the case of a 13-year old girl with metastatic papillary RCC and to review the literature mainly on treatment modalities and prognosis of children and adolescents with RCC. PRESENTATION OF CASE The case of a 13-year old girl is presented. The girl presented with a painless abdominal mass in the right side for three months. Abdominal ultrasound revealed a heterogeneous mass of 15 cm in diameter with metastasis to the liver. Also CT scan of the abdomen and lungs revealed metastasis to the liver and lungs. She underwent radical right nephrectomy. DISCUSSION Pediatric RCC is an aggressive malignancy and some series have reported a 50% incidence of metastasis at the point of initial diagnosis similar to our patient who had metastasis to both lungs and liver at the time of initial diagnosis. Over 50% of metastasis of RCC in the pediatric population occurs in the lungs and liver. CONCLUSION RCC in children is extremely rare with no known specific treatment regimen. Early diagnosis when the tumour is still confined to the kidney provides better clinical outcomes since radiotherapy, chemotherapy and immunotherapy have not been found to improve the prognosis.
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Affiliation(s)
- James J Yahaya
- Department of Biomedical Science, College of Health Sciences (CHS), The University of Dodoma, Dodoma, Tanzania
| | - Nicholas Bartholomew
- Department of Urology, Kilimanjaro Christian Medical Center (KCMC), Moshi, Tanzania
| | - Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Center (KCMC), Moshi, Tanzania; Faculty of Medicine, Kilimanajro Christian Medical University College (KCMUCO), Moshi, Tanzania
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7
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Ray S, Jones R, Pritchard-Jones K, Dzhuma K, van den Heuvel-Eibrink M, Tytgat G, van der Beek J, Oades G, Murphy D. Pediatric and young adult renal cell carcinoma. Pediatr Blood Cancer 2020; 67:e28675. [PMID: 32869954 DOI: 10.1002/pbc.28675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 12/11/2022]
Abstract
Renal cell carcinoma (RCC) is rare in children but is the most common renal tumor in adults. Pediatric RCC has different clinical characteristics, histopathology, and treatment compared with adult disease. Databases were reviewed from inception to February 2020, identifying 32 publications pertaining to 350 patients under 27 years. Surgery is the cornerstone for cure in localized RCC. Lymph node dissection remains controversial. Conventional radiotherapy has no curative role in RCC; similarly, conventional chemotherapy has not proven to be effective in large cohorts. Pediatric metastatic RCC has a poor outlook. There are no published prospective studies demonstrating which adjuvant therapy could improve outcome. Sunitinib, a tyrosine kinase inhibitor, is recommended in this group despite limited evidence. This review provides an overview for pediatric RCC, including the evolving role of precision medicine.
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Affiliation(s)
- Satyajit Ray
- Department of Paediatric Oncology, Royal Hospital for Children, Glasgow, Scotland, UK
| | - Robert Jones
- Beatson West of Scotland Cancer Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland, UK
| | | | - Kristina Dzhuma
- University College London Institute of Child Health, London, UK
| | | | - Godelieve Tytgat
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Grenville Oades
- Department of Uro-Oncology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Dermot Murphy
- Department of Paediatric Oncology, Royal Hospital for Children, Glasgow, Scotland, UK
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8
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Rossi E, Zin A, Facchinetti A, Poggiana C, Tombolan L, Affinita MC, Bonvini P, Santoro L, Schiavi F, Bisogno G, Zamarchi R. Liquid Biopsy in Pediatric Renal Cancer: Stage I and Stage IV Cases Compared. Diagnostics (Basel) 2020; 10:E810. [PMID: 33053902 PMCID: PMC7599903 DOI: 10.3390/diagnostics10100810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022] Open
Abstract
Pediatric renal cancer is rare, and robust evidence for treatment recommendations is lacking. In the perspective of personalized medicine, clinicians need new biomarkers to improve risk stratification and patients' follow-up. Herein, we analyzed some liquid biopsy tools, which have been never tested in pediatric renal cancer: namely, circulating tumor cells (CTCs); the expression of M30, an apoptosis marker, to test CTC metastatic potential; and c-MET expression in CTCs, because of its role in renal cancer progression and drug-resistance. Furthermore, we evaluated the Circulating Endothelial Cells (CECs), whose utility we previously demonstrated in adult metastatic renal cancer treated with anti-angiogenic therapy. We compared two renal cell carcinomas of clear-cell type, stage I and IV, which underwent surgery and surgery plus Sunitinib, respectively. Baseline CTC level and its changes during follow-up were consistent with patients' outcome. In case 2, stage IV, the analysis of CECs performed during Sunitinib revealed a late response to treatment consistent with poor outcome, as the finding of M30-negative, viable cells. Noteworthily, few CTCs were MET-positive in both cases. Our study highlights the feasibility for a change in the prognostic approach and follow-up of childhood renal cancer, with a view to guide a better treatment design.
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Affiliation(s)
- Elisabetta Rossi
- Department of Surgery, Oncology and Gastroenterology, Oncology Section, University of Padova, Padua, Italy; (E.R.); (A.F.)
- Veneto Institute of Oncology IOV—IRCCS, Padua, Italy; (C.P.); (F.S.)
| | - Angelica Zin
- Institute of Pediatric Research, Fondazione Città della Speranza, Padua, Italy; (A.Z.); (L.T.); (P.B.)
| | - Antonella Facchinetti
- Department of Surgery, Oncology and Gastroenterology, Oncology Section, University of Padova, Padua, Italy; (E.R.); (A.F.)
- Veneto Institute of Oncology IOV—IRCCS, Padua, Italy; (C.P.); (F.S.)
| | - Cristina Poggiana
- Veneto Institute of Oncology IOV—IRCCS, Padua, Italy; (C.P.); (F.S.)
| | - Lucia Tombolan
- Institute of Pediatric Research, Fondazione Città della Speranza, Padua, Italy; (A.Z.); (L.T.); (P.B.)
| | - Maria Carmen Affinita
- Department of Woman’s and Children’s Health, Hematology and Oncology Unit, University of Padua, Padua, Italy; (M.C.A.); (G.B.)
| | - Paolo Bonvini
- Institute of Pediatric Research, Fondazione Città della Speranza, Padua, Italy; (A.Z.); (L.T.); (P.B.)
| | - Luisa Santoro
- University Hospital of Padova, Institute of Pathology, Padua, Italy;
| | - Francesca Schiavi
- Veneto Institute of Oncology IOV—IRCCS, Padua, Italy; (C.P.); (F.S.)
| | - Gianni Bisogno
- Department of Woman’s and Children’s Health, Hematology and Oncology Unit, University of Padua, Padua, Italy; (M.C.A.); (G.B.)
| | - Rita Zamarchi
- Veneto Institute of Oncology IOV—IRCCS, Padua, Italy; (C.P.); (F.S.)
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9
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Lehmann N, Paret C, El Malki K, Russo A, Neu MA, Wingerter A, Seidmann L, Foersch S, Ziegler N, Roth L, Backes N, Sandhoff R, Faber J. Tumor Lipids of Pediatric Papillary Renal Cell Carcinoma Stimulate Unconventional T Cells. Front Immunol 2020; 11:1819. [PMID: 32973759 PMCID: PMC7468390 DOI: 10.3389/fimmu.2020.01819] [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: 01/31/2020] [Accepted: 07/07/2020] [Indexed: 01/25/2023] Open
Abstract
Papillary renal cell carcinoma (PRCC) is a rare entity in children with no established therapy protocols for advanced diseases. Immunotherapy is emerging as an important therapeutic tool for childhood cancer. Tumor cells can be recognized and killed by conventional and unconventional T cells. Unconventional T cells are able to recognize lipid antigens presented via CD1 molecules independently from major histocompatibility complex, which offers new alternatives for cancer immunotherapies. The nature of those lipids is largely unknown and α-galactosylceramide is currently used as a synthetic model antigen. In this work, we analyzed infiltrating lymphocytes of two pediatric PRCCs using flow cytometry, immunohistochemistry and qRT-PCR. Moreover, we analyzed the CD1d expression within both tumors. Tumor lipids of PRCC samples and three normal kidney samples were fractionated and the recognition of tumor own lipid fractions by unconventional T cells was analyzed in an in vitro assay. We identified infiltrating lymphocytes including γδ T cells and iNKT cells, as well as CD1d expression in both samples. One lipid fraction, containing ceramides and monoacylglycerides amongst others, was able to induce the proliferation of iNKT cells isolated from peripheral blood mononuclear cells (PBMCs) of healthy donors and of one matched PRCC patient. Furthermore, CD1d tetramer stainings revealed that a subset of iNKT cells is able to bind lipids being present in fraction 2 via CD1d. We conclude that PRCCs are infiltrated by conventional and unconventional T cells and express CD1d. Moreover, certain lipids, present in pediatric PRCC, are able to stimulate unconventional T cells. Manipulating these lipids and T cells may open new strategies for therapy of pediatric PRCCs.
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Affiliation(s)
- Nadine Lehmann
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Claudia Paret
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Khalifa El Malki
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexandra Russo
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Marie Astrid Neu
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Arthur Wingerter
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Larissa Seidmann
- Institute of Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sebastian Foersch
- Institute of Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nicole Ziegler
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lea Roth
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nora Backes
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Roger Sandhoff
- Lipid Pathobiochemistry, German Cancer Research Center, Heidelberg, Germany
| | - Joerg Faber
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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10
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van der Beek JN, Geller JI, de Krijger RR, Graf N, Pritchard-Jones K, Drost J, Verschuur AC, Murphy D, Ray S, Spreafico F, Dzhuma K, Littooij AS, Selle B, Tytgat GAM, van den Heuvel-Eibrink MM. Characteristics and Outcome of Children with Renal Cell Carcinoma: A Narrative Review. Cancers (Basel) 2020; 12:E1776. [PMID: 32635225 PMCID: PMC7407101 DOI: 10.3390/cancers12071776] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022] Open
Abstract
Pediatric renal cell carcinoma (RCC) is a rare type of kidney cancer, most commonly occurring in teenagers and young adolescents. Few relatively large series of pediatric RCC have been reported. Knowledge of clinical characteristics, outcome and treatment strategies are often based on the more frequently occurring adult types of RCC. However, published pediatric data suggest that clinical, molecular and histological characteristics of pediatric RCC differ from adult RCC. This paper summarizes reported series consisting of ≥10 RCC pediatric patients in order to create an up-to-date overview of the clinical and histopathological characteristics, treatment and outcome of pediatric RCC patients.
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Affiliation(s)
- Justine N. van der Beek
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - James I. Geller
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (K.P.-J.); (K.D.)
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Oncode Institute, 3521 AL Utrecht, The Netherlands
| | - Arnauld C. Verschuur
- Department of Pediatric Oncology, Hôpital d’Enfants de la Timone, APHM, 13005 Marseille, France;
| | - Dermot Murphy
- Department of Paediatric Oncology, Royal Hospital for Children, Glasgow G51 4TF, Scotland; (D.M.); (S.R.)
| | - Satyajit Ray
- Department of Paediatric Oncology, Royal Hospital for Children, Glasgow G51 4TF, Scotland; (D.M.); (S.R.)
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
| | - Kristina Dzhuma
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (K.P.-J.); (K.D.)
| | - Annemieke S. Littooij
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Barbara Selle
- Department of Pediatric Hematology and Oncology, St. Annastift Children’s Hospital, 67065 Ludwigshafen, Germany;
| | - Godelieve A. M. Tytgat
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (A.S.L.); (G.A.M.T.); (M.M.v.d.H.-E.)
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11
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Abdulfatah E, Kennedy JM, Hafez K, Davenport MS, Xiao H, Weizer AZ, Palapattu GS, Morgan TM, Mannan R, Wang XM, Dhanasekaran SM, Kaffenberger SD, Spratt DE, Kunju L, Wu A, Lew M, Udager AM, Chinnaiyan AM, Mehra R. Clinicopathological characterisation of renal cell carcinoma in young adults: a contemporary update and review of literature. Histopathology 2020; 76:875-887. [PMID: 31872452 DOI: 10.1111/his.14051] [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: 10/02/2019] [Accepted: 12/21/2019] [Indexed: 11/28/2022]
Abstract
AIMS Renal cell carcinomas are relatively rare in children and young adults. While well characterised in adults, the morphological and molecular characterisation of these tumours in young patients is relatively lacking. The objective of this study was to explore the spectrum of renal cell carcinoma (RCC) subtypes in children and young adults and to determine their clinico-pathological, immunohistochemical and molecular characteristics by evaluating a large retrospective cohort of renal cell carcinoma patients age 30 years or younger. METHODS AND RESULTS Sixty-eight cases with confirmed diagnosis of renal cell carcinoma at age 30 years or younger were identified at our institution. Clear cell carcinoma accounted for the most common subtype seen in this age group. Translocation renal cell carcinoma and rare familial syndrome subtypes such as succinate dehydrogenase deficient renal cell carcinoma and tuberous sclerosis complex-associated renal cell carcinoma were found relatively more frequently in this cohort. Despite applying the 2016 WHO classification criteria, a high proportion of the tumours in our series remained unclassified. CONCLUSIONS Our results suggest that renal cell carcinoma in children and young adults is a relatively rare disease that shares many histological similarities to renal cell carcinoma occurring in adults and yet demonstrate some unique clinical-pathological differences. Microphthalmia-associated transcription (MiT) family translocation RCC and rare familial syndrome subtypes are relatively more frequent in the paediatric and adolescent age groups than in adults. Clear cell RCC still accounted for the most common subtype seen in this age group. MiT family translocation RCC patients presented with advanced stage disease and had poor clinical outcomes. The large and heterogeneous subgroup of unclassified renal cell carcinoma contains phenotypically distinct tumours with further potential for future subcategories in the renal cell carcinoma classification.
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Affiliation(s)
- Eman Abdulfatah
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - John M Kennedy
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Khaled Hafez
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Matthew S Davenport
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Hong Xiao
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Alon Z Weizer
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ganesh S Palapattu
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Todd M Morgan
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rahul Mannan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Xiao-Ming Wang
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Saravana M Dhanasekaran
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | | | - Daniel E Spratt
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Lakshmi Kunju
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Angela Wu
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Aaron M Udager
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA.,Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA.,Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA.,Howard Hughes Medical Institute, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA.,Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA
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12
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13
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Ogunmola OJ, Onyema C, Babatunde Bakare TI, Olabinri EO, Bamigboye-Taiwo OT, Adaje AO, Lawal OA. A 10-Year Old Girl with Resistant Hypertension without Significant Indication of an Underlying Renal Cell Carcinoma, Misdiagnosed as Malaria. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1434-1439. [PMID: 31563918 PMCID: PMC6788490 DOI: 10.12659/ajcr.916588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patient: Female, 10 Final Diagnosis: Arterial hypertension secondary to renal cell carcinoma Symptoms: Recurrent headaches • excessive sweating • anorexia • weight loss • easy fatigability Medication: — Clinical Procedure: Nephrectomy Specialty: Pediatrics and Neonatology
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Affiliation(s)
| | - Clifford Onyema
- Department of Pediatrics, Federal Teaching Hospital Ido Ekiti, Ekiti State, Nigeria
| | | | | | | | | | - Olubunmi Adeola Lawal
- Department of Paediatrics, Federal Teaching Hospital Ido Ekit , Ekiti State, Nigeria
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14
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Abstract
PURPOSE OF REVIEW To review the presentation, natural history and treatment of renal cell carcinoma in children and young adults with renal cell carcinoma (RCC). RECENT FINDINGS Complete resection of lymph nodes at the time of tumor resection can improve clinical outcomes and limit the need for adjuvant chemotherapy. Genetic alterations that lead to translocation tumors are a therapeutic target of receptor tyrosine kinase inhibitors. SUMMARY The incidence of RCC increases with age. Unlike adult patients, young patients with RCC present symptomatically and at higher stage and grade. Translocation tumors predominate RCC in children with biologic activity characterized by early spread to lymph nodes with small primary tumors. Preoperative imaging is poorly sensitive for positive lymph nodes; as such, surgeons should have a low threshold for lymph node sampling during tumor resection. Despite the advanced stage at presentation, the prognosis in children is more favorable than their adult counterparts. Complete resection of lymph nodes at the time of surgical resection improves patient prognosis. Chemotherapy targeting the PI3/AKT pathway has demonstrated clinical benefit.
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15
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Li Y, Reuter VE, Matoso A, Netto GJ, Epstein JI, Argani P. Re-evaluation of 33 'unclassified' eosinophilic renal cell carcinomas in young patients. Histopathology 2018; 72:588-600. [PMID: 28898443 PMCID: PMC7582203 DOI: 10.1111/his.13395] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/07/2017] [Indexed: 12/16/2022]
Abstract
AIMS We sought to determine if some unclassified renal cell carcinomas (RCCs) in children and young adults that are characterised by predominantly eosinophilic cytoplasm are related to the recently described succinate dehydrogenase (SDH)-deficient RCC, fumarate hydratase (FH)-deficient RCC or eosinophilic solid and cystic (ESC) RCC. METHODS AND RESULTS We reviewed 33 unclassified RCCs with predominantly eosinophilic cytoplasm in patients aged 35 years or younger. Immunohistochemistry (IHC) for SDHB, FH and CK20 (a marker of ESC) was performed in all cases. IHC for 2-succinocysteine (2SC) was performed on RCC with loss of FH labelling. Four RCC (12%) (median age 18 years) demonstrated loss of FH labelling as well as aberrant 2SC labelling, and were thus classified as FH-deficient RCCs. Importantly, none of these cases demonstrated the characteristic macronucleoli typical of FH-deficient RCC. Eight RCC (24%) (median age 20.5 years) demonstrated loss of SDHB and were reclassified as SDH-deficient RCCs. Importantly, only four of eight SDH-deficient RCC demonstrated the characteristic cytoplasmic vacuoles and inclusions of typical SDH-deficient RCC. Ten RCC (30%) (median age 27 years) were reclassified as ESC RCCs. Four of 10 ESC RCC were multifocal (one bilateral), four of 10 ESC RCC occurred in males and one patient presented with liver and lung metastases, all not described previously in ESC. Eleven RCC (33%) remained unclassified. CONCLUSIONS Pathologists should have a low threshold for performing FH, SDHB and CK20 IHC when confronted with unclassified eosinophilic RCC or 'oncocytoma' in young patients.
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Affiliation(s)
- Yunjie Li
- Johns Hopkins University School of Medicine, Pathology, Baltimore, MD, United States
| | - Victor E Reuter
- Memorial Sloan Kettering Cancer Center, Pathology, New York, NY, United States
| | - Andres Matoso
- Johns Hopkins University School of Medicine, Pathology, Baltimore, MD, United States
| | - George J Netto
- Johns Hopkins University School of Medicine, Pathology, Baltimore, MD, United States
- University of Alabama at Birmingham School of Medicine, Birmingham,AL, USA
| | - Jonathan I Epstein
- Johns Hopkins University School of Medicine, Pathology, Baltimore, MD, United States
| | - Pedram Argani
- Johns Hopkins University School of Medicine, Pathology, Baltimore, MD, United States
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16
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Succinate Dehydrogenase Deficiency in a Child with Bilateral Renal Cell Carcinoma. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Weisbach L, Aziz A, Fisch M, Riechardt S. [Renal cell carcinomas in childhood]. Urologe A 2017; 56:900-904. [PMID: 28600591 DOI: 10.1007/s00120-017-0420-6] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND Renal cell carcinoma is a rare childhood disease. However, it should be considered in the differential diagnosis in the detection of a renal mass. OBJECTIVES Incidence and mortality of renal cell carcinomas in childhood. Presentation of clinical symptoms, diagnostics, histology, therapy and course of the disease. PATIENTS AND METHODS Evaluation of our own prospective data of a small patient population of 8 patients, as well as discussion of the current literature on this tumor entity. RESULTS The average follow-up period was 27 months. Preoperative staging studies showed no metastases. The histologically primary predominant subtype was papillary renal cell carcinoma. Tumor stage and lymph node status were the most important prognostic factors in our study. CONCLUSIONS Renal cell carcinoma in childhood is a rare disease whose treatment is challenging and should be performed in an interdisciplinary team. Typical clinical symptoms, as in adults, are absent. The partial nephrectomy should be, if practicable, the surgical treatment of choice. The most important risk factors for survival are tumor stage and lymph node status. Data on adjuvant target therapy for metastatic disease in childhood are lacking. Further prospective, multicenter studies are necessary to generate more information on the biology and course of this disease and to obtain adjuvant treatment options in locally advanced disease.
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Affiliation(s)
- L Weisbach
- Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - A Aziz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - M Fisch
- Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - S Riechardt
- Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
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18
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Syed JS, Nguyen KA, Wu CQ, Cost NG, Siddiqui MM, Hittelman AB, Shuch B. Distinguishing pediatric and adolescent renal cell carcinoma from other renal malignancies. Pediatr Blood Cancer 2017; 64. [PMID: 27805307 DOI: 10.1002/pbc.26315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/19/2016] [Accepted: 09/23/2016] [Indexed: 12/28/2022]
Abstract
PURPOSE Renal cell carcinoma (RCC) represents a small proportion of renal malignancies early in life. Distinguishing RCC from other malignancies is important as treatment strategies may differ. We analyze the Surveillance Epidemiology, and End Results (SEER) database to identify predictive factors of RCC in the pediatric population with renal tumors. METHODS We queried SEER to identify patients from ages 0 to 19 diagnosed with a renal malignancy between 1973 and 2013. Cases were sorted using histology and site codes. Age-adjusted standardized incidence rates (SIR) were calculated. We compared differences in characteristics between cancer types. A logistic regression model and a nomogram were created to identify predictors of RCC. RESULTS A total of 3,670 patients were identified, of which 281 (7.7%) were diagnosed with RCC. The SIR of RCC increased with age. After age 12, RCC was found in >50% of all newly diagnosed cases. On multivariate analysis, RCC was associated with smaller tumor size (P < 0.001), increasing age (P < 0.001), black race (P < 0.001), and localized stage (P < 0.001). The nomogram predicted RCC pathology with a concordance index of 0.965. CONCLUSIONS RCC in childhood and adolescence is relatively uncommon; however, it accounts for >50% of renal malignancies after age 12. For every year of increasing age, the odds of having an RCC diagnosis are increased by 50%. The odds of a renal tumor being RCC are increased in black children, those with localized disease, and those with smaller tumors. In these specific populations, RCC should be favored in the differential diagnosis of the renal mass.
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Affiliation(s)
- Jamil S Syed
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
| | - Kevin A Nguyen
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
| | - Charlotte Q Wu
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
| | - Nicholas G Cost
- Division of Urology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Mohummad M Siddiqui
- Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Adam B Hittelman
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
| | - Brian Shuch
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
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19
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Lee SW. Renal Tumors in Children. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2017. [DOI: 10.15264/cpho.2017.24.1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Seong Wook Lee
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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20
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Leahy M, Spreafico F, Bleyer A. Cancer of the Kidney, Bladder, and Prostate. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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21
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Young EE, Brown CT, Merguerian PA, Akhavan A. Pediatric and adolescent renal cell carcinoma. Urol Oncol 2016; 34:42-9. [DOI: 10.1016/j.urolonc.2015.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/16/2015] [Accepted: 06/16/2015] [Indexed: 12/13/2022]
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22
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Kim JH, Seo SI, Song C, Chung J, Kwak C, Hong SH. Clinicohistological characteristics of renal cell carcinoma in children: A multicentre study. Can Urol Assoc J 2015; 9:E705-8. [PMID: 26664504 DOI: 10.5489/cuaj.2855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In this retrospective multicentre study, we compared the clinicohistological characteristics of renal cell carcinoma (RCC) between pediatric and adult patients. METHODS Data for patients who underwent radical or partial nephrectomy for RCC between 1988 and 2014 at multiple institutions were collected. Patients were divided into 2 groups according to age at diagnosis: pediatric patients (age ≤18 years) and adult patients (age ≥40 years). The groups were compared for clinical and pathologic variables, and survival analysis was performed. RESULTS The median follow-up period was 64 (range: 30-91) months for pediatric patients versus 44 (range: 19-59) months for adult patients (p = 0.026). Pediatric patients were mostly female (p = 0.003), had symptoms at presentation (p < 0.001), and had a high-stage tumour (p = 0.014) than adult patients. Among the symptomatic patients, gross hematuria was the most common symptom. The median tumour size was not different between groups. Regarding histologic types, pediatric patients had more papillary tumours (p < 0.001), more unclassified tumours (p < 0.001), and fewer clear cell carcinomas (p < 0.001). Five-year cancer-specific survival rates were 85% and 87.4% in pediatric and adult patients, respectively (log rank p = 0.901). Recurrence-free survival was better in adult patients, although this did not reach statistical significance (log rank p = 0.272). This study has several limitations, including its retrospective nature and the relatively small number of pediatric RCC cases. CONCLUSION RCC in children is rare and is characterized by features that differ from those in adult RCC. Prognosis did not differ between groups.
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Affiliation(s)
- Jeong Ho Kim
- Department of Urology, Dongnam Institute of Radiological & Medical Sciences Cancer center, Busan, Korea
| | - Seong Il Seo
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheryn Song
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jinsoo Chung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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23
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Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature. Case Rep Pathol 2015; 2015:841237. [PMID: 26301110 PMCID: PMC4537719 DOI: 10.1155/2015/841237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/21/2015] [Indexed: 11/20/2022] Open
Abstract
Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.
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24
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Okabe K, Kitamura H, Nishiyama N, Masumori N. A case of chromophobe renal cell carcinoma in a 12-year-old girl. Int Cancer Conf J 2015; 5:36-39. [PMID: 31149420 DOI: 10.1007/s13691-015-0221-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/23/2015] [Indexed: 11/28/2022] Open
Abstract
Renal cell carcinoma (RCC) accounts for only 2-6 % of pediatric renal tumors. Chromophobe RCC is very rare in pediatric patients, with only a few cases reported. A 12-year-old girl who had abdominal and left flank pain visited the pediatric clinic of a local hospital. A uniformly enhanced tumor measuring 2.5 cm × 2.3 cm was found on computed tomography. On magnetic resonance imaging, T2-weighted images showed a solid tumor with hyperintensity suggesting intratumoral necrosis. We considered RCC and Wilms' tumor as differential diagnoses, but we could not reach a definitive diagnosis from the radiographic findings. We then performed right partial nephrectomy with regional lymph node dissection. The histopathological diagnosis was pT1aN0 chromophobe RCC. After the surgery, no recurrence has been observed for 15 months.
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Affiliation(s)
- Ko Okabe
- Department of Urology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8543 Japan
| | - Hiroshi Kitamura
- Department of Urology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8543 Japan
| | - Naotaka Nishiyama
- Department of Urology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8543 Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8543 Japan
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25
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Abdellah A, Selma K, Elamin M, Asmae T, Lamia R, Abderrahmane M, Sanaa EM, Hanan E, Tayeb K, Noureddine B. Renal cell carcinoma in children: case report and literature review. Pan Afr Med J 2015; 20:84. [PMID: 26090042 PMCID: PMC4450035 DOI: 10.11604/pamj.2015.20.84.5791] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 01/08/2015] [Indexed: 01/29/2023] Open
Abstract
Renal cell carcinoma is infrequent in children; consequently it is important to communicate its diagnosis and follow up. The behaviour of this type of tumor is better characterized in adults and in this setting the treatment of choice is surgical resection. However, the place of chemo- and radiotherapy has not been well defined. Here, we present a 9-year-old boy with renal cell carcinoma demonstrating only hematuria without any pathological physical examination findings. The mass was described by abdominal ultrasonography and computed tomography in the left kidney. After the left nephroureterectomy, the patient was given no adjuvant therapy.
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Affiliation(s)
- Aissa Abdellah
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Kadiri Selma
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Marnouche Elamin
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Touil Asmae
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Rouas Lamia
- Department of Pathology, pediatrics hospital, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Malihy Abderrahmane
- Department of Pathology, pediatrics hospital, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - El Majjaoui Sanaa
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Elkacemi Hanan
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Kebdani Tayeb
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Benjaafar Noureddine
- Department of Radiation Oncology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
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26
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Malkan AD, Loh A, Bahrami A, Navid F, Coleman J, Green DM, Davidoff AM, Sandoval JA. An approach to renal masses in pediatrics. Pediatrics 2015; 135:142-58. [PMID: 25452658 DOI: 10.1542/peds.2014-1011] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Renal masses in children may be discovered during routine clinical examination or incidentally during the course of diagnostic or therapeutic procedures for other causes. Renal cancers are rare in the pediatric population and include a spectrum of pathologies that may challenge the clinician in choosing the optimal treatment. Correct identification of the lesion may be difficult, and the appropriate surgical procedure is paramount for lesions suspected to be malignant. The purpose of this article is to provide a comprehensive overview regarding the spectrum of renal tumors in the pediatric population, both benign and malignant, and their surgical management.
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Affiliation(s)
| | | | | | - Fariba Navid
- Oncology, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Daniel M Green
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee; and
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27
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Akhavan A, Richards M, Shnorhavorian M, Goldin A, Gow K, Merguerian PA. Renal cell carcinoma in children, adolescents and young adults: a National Cancer Database study. J Urol 2014; 193:1336-41. [PMID: 25451825 DOI: 10.1016/j.juro.2014.10.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE We compared the presentation and outcomes of patients younger than 21 years with renal cell carcinoma and determined risk factors associated with mortality. MATERIALS AND METHODS We searched the National Cancer Database for patients diagnosed with renal cell carcinoma between 1998 and 2011. We evaluated patients younger than 30 years with renal cell carcinoma, including clear cell, chromophobe, papillary and not otherwise specified subcategories. We used logistic regression to compare presenting cancer, demographics and treatment variables in patients 0 to 15 years, 15 to 21 years and 21 to 30 years old. Cox regression analysis was used to determine risk factors for mortality in patients younger than 21. RESULTS Of 3,658 patients younger than 30 years included in the study 161 were younger than 15 and 337 were 15 to 21 years old. A higher proportion of younger patients had renal cell carcinoma not otherwise specified and papillary histology compared to those 21 to 30 years (p < 0.001). Younger patients presented with higher stage (p < 0.0001), higher grade (p < 0.0001) and larger tumors (p < 0.0001) than those 21 to 30 years. A higher percentage of younger patients underwent lymph node dissection (p < 0.0001) or chemotherapy as first-line treatment (p < 0.0001) compared to those 21 to 30 years. Cox regression analysis demonstrated that stage 4 presentation, government insurance status, nonchromophobic pathology results and not undergoing surgery as first-line treatment were independently associated with increased mortality in patients younger than 21 years. CONCLUSIONS Children and adolescents with renal cell carcinoma present with more advanced disease than those 21 to 30 years old. In patients younger than 21 years mortality was associated with the nonchromophobe histological subtype, stage 4 disease, government insurance and not undergoing surgery as first-line therapy.
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Affiliation(s)
- Ardavan Akhavan
- Department of Urology, Division of Pediatric Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Morgan Richards
- Department of Urology, Division of Pediatric Urology, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Margarett Shnorhavorian
- Department of Urology, Division of Pediatric Urology, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Adam Goldin
- Department of Surgery, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Kenneth Gow
- Division of General and Thoracic Surgery, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Paul A Merguerian
- Department of Urology, Division of Pediatric Urology, University of Washington, Seattle Children's Hospital, Seattle, Washington
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Dome JS, Fernandez CV, Mullen EA, Kalapurakal JA, Geller JI, Huff V, Gratias EJ, Dix DB, Ehrlich PF, Khanna G, Anderson JR, Naranjo A, Perlman EJ, Perlman EJ. Children's Oncology Group's 2013 blueprint for research: renal tumors. Pediatr Blood Cancer 2013; 60:994-1000. [PMID: 23255438 PMCID: PMC4127041 DOI: 10.1002/pbc.24419] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 11/07/2012] [Indexed: 12/12/2022]
Abstract
Renal malignancies are among the most prevalent pediatric cancers. The most common is favorable histology Wilms tumor (FHWT), which has 5-year overall survival exceeding 90%. Other pediatric renal malignancies, including anaplastic Wilms tumor, clear cell sarcoma, malignant rhabdoid tumor, and renal cell carcinoma, have less favorable outcomes. Recent clinical trials have identified gain of chromosome 1q as a prognostic marker for FHWT. Upcoming studies will evaluate therapy adjustments based on this and other novel biomarkers. For high-risk renal tumors, new treatment regimens will incorporate biological therapies. A research blueprint, viewed from the perspective of the Children's Oncology Group, is presented.
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Affiliation(s)
- Jeffrey S. Dome
- Division of Oncology, Center for Cancer and Blood Disorders, Children’s National Medical Center, Washington, DC,Correspondence to: Jeffrey S. Dome, MD, PhD, Division of Oncology, Center for Cancer and Blood Disorders, Children’s National Medical Center, 111 Michigan Avenue NW, Washington DC 20010,
| | | | | | - John A. Kalapurakal
- Department of Radiation Oncology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - James I. Geller
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Vicki Huff
- Department of Genetics, MD Anderson Cancer Center, Houston, TX
| | - Eric J. Gratias
- Division of Hematology/Oncology, Children’s Hospital at Erlanger, University of Tennessee College of Medicine, Chattanooga, TN
| | - David B. Dix
- Pediatric Hematology/Oncology, British Columbia Children’s Hospital, Vancouver, BC
| | - Peter F. Ehrlich
- Department of Pediatric Surgery, University of Michigan, CS Mott Children’s Hospital, Ann Arbor, MI
| | - Geetika Khanna
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | | | - Arlene Naranjo
- Department of Biostatistics, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, Florida
| | - Elizabeth J. Perlman
- Department of Pathology, Northwestern University’s Feinberg School of Medicine and the Robert H. Lurie Cancer Center, Chicago, IL
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Abstract
BACKGROUND Because of the rare occurrence of renal cell carcinoma (RCC) among children very little is known about this malignancy in pediatric age. We aimed adding knowledge on the clinical characteristics and outcome of metastatic (m) RCC in children and adolescents. PATIENTS AND METHODS The series included 14 stage 4 RCC patients with a median age at diagnosis of 155.5 months, observed at the Italian Pediatric Hematology and Oncology Association (AIEOP) centers from January 1973 to November 2010. We were able to reevaluate histopatology of 11 out of the 14 patients and perform immunostaining for TFE3 in 9 out of the 11 patients. RESULTS Of the 14 patients under study, 5 (3 girls) had a translocation morphology TFE+ RCC, 2 were reassigned as papillary type 1 or 2, respectively, 2 tumor specimens with primary clear cell histology had confirmed the initial histologic diagnosis, and 2-whose biopsy specimen was insufficient-had the diagnosis of RCC not further specified with subtyping. In the remaining 3 cases, the initial diagnosis of clear cell carcinoma was left. Overall, 6 patients received chemotherapy, 9 immunotherapy, and 2 adjuvant antiangiogenic therapy. Overall, 11 patients (78.5%) never achieved complete remission and died from progressive disease 1 to 16 months after diagnosis (median overall survival 5.5 mo). Three patients, 2 of whom received adjuvant antiangiogenic therapy, relapsed to lung at 3, 6, and 8 months after diagnosis, and died 18, 32, and 33 months after diagnosis, respectively. CONCLUSIONS Despite their possibly different biology, childhood and adult mRCC seems to be sharing comparable outcomes. Because of the very low incidence of mRCC (about 20%) in children and adolescents, an international pediatric cooperation to address biological studies and assess the novel targeted approaches is needed.
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Cloutier J, Aziz A, Inman B, Bolduc S. Bilateral renal cell carcinoma in a child. Urology 2012; 80:430-3. [PMID: 22386253 DOI: 10.1016/j.urology.2012.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 12/31/2011] [Accepted: 01/09/2012] [Indexed: 10/28/2022]
Abstract
Renal cell carcinoma is a rare renal tumor in the pediatric population with an incidence of 0.1-0.3%. We report on the first case of bilateral renal clear cell carcinoma that was treated by partial nephrectomies. We performed a complete genetic evaluation to exclude a family inheritance and we looked at the deletions associated with the possible histologic subtypes of renal cell carcinoma. The patient had no evidence of recurrence after 80-month follow-up and her renal function remained normal.
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Affiliation(s)
- Jonathan Cloutier
- Division of Urology, Centre Hospitalier Universitaire de Québec (CHUQ), Université Laval, Quebec, Canada
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31
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Renal cell carcinoma presented with hypocalcemia in an adolescent. J Pediatr Hematol Oncol 2012; 34:e56-8. [PMID: 22367390 DOI: 10.1097/mph.0b013e318212250a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Renal cell carcinoma is very rare in childhood. It is a different entity from its adult counterpart. We report a case of renal cell carcinoma presented with hypocalcemia in a 16-year-old girl that is, to the best of our knowledge, the first such published incident. The patient was treated by radical nephrectomy with regional lymphadenectomy. Hypocalcemia amended after surgery. Neither chemotherapy nor radiotherapy was given. She has remained disease free for 34 months.
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TFE3 Translocation-Associated Renal Cell Carcinoma Presenting as Avascular Necrosis of the Femur in a 19-Year-Old Patient: Case Report and Review of the Literature. Case Rep Med 2011; 2011:432917. [PMID: 22007232 PMCID: PMC3189466 DOI: 10.1155/2011/432917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 07/14/2011] [Indexed: 01/20/2023] Open
Abstract
In the United States, renal cell carcinoma (RCC) accounts for approximately 3% of adult malignancies and 90–95% of all neoplasms arising from the kidney. According to the National Cancer Institute, 58 240 new cases and 13 040 deaths from renal cancer will occur in 2010. RCC usually occurs in older adults between the ages of 50 and 70 and is rare in young adults and children. We describe a case of a TFE3 translocation-associated RCC in a 19-year-old patient presenting as avascular necrosis of the femur. Due to the rarity of this malignancy, we present this case including a review of the existing literature relative to diagnosis and treatment.
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Continuing response to subsequent treatment lines with tyrosine kinase inhibitors in an adolescent with metastatic renal cell carcinoma. J Pediatr Hematol Oncol 2011; 33:e176-9. [PMID: 21552143 DOI: 10.1097/mph.0b013e3182028fd9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 14-year-old girl with metastatic renal cell carcinoma was treated with nephrectomy, interferon, and several lines of the targeted agents sorafenib, bevacizumab, sunitinib, and everolimus, either alone or in combination. Treatment was well tolerated, but the patient developed hypothyroidism and significant hypertension with bevacizumab and sunitinib. She responded to all agents and was given radiation treatment twice at the time of symptomatic disease progression; she died 33 months from diagnosis.
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Popov SD, Sebire NJ, Pritchard-Jones K, Vujanić GM. Renal tumors in children aged 10-16 Years: a report from the United Kingdom Children's Cancer and Leukaemia Group. Pediatr Dev Pathol 2011; 14:189-93. [PMID: 21054158 DOI: 10.2350/10-06-0855-oa.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Wilms tumor is the most common renal tumor of childhood. However, other epithelial, mesenchymal, and neuroectodermal neoplasms may also arise in the kidney during childhood, several of which show specific age distributions; in the 1st year of life, mesoblastic nephroma and rhabdoid tumor are more common, whereas renal cell carcinoma, primitive neuroectodermal tumor, and anaplastic Wilms tumors are relatively more frequent in older children and adolescents. The aim of this study is to describe the spectrum of renal tumors in children aged 10-16 years using data from 1492 patients registered in the UK Wilms Tumour 3 Trial (1991-2001) and International Society of Paediatric Oncology Wilms Tumour Trial 2001 (2002-2008) clinical trials of renal tumors in childhood. There were 67 (4.6%) tumors in children aged 10-16 years: 50 Wilms tumors (74.6%), 10 (14.9%) renal cell carcinomas, 3 (4.5%) renal medullary carcinomas, 2 (3%) primitive neuroectodermal tumors, 1 clear cell sarcoma of kidney, and 1 desmoplastic small round cell tumor. Fourteen percent of the Wilms tumors in this age group had diffuse anaplasia. Among the 10 renal cell carcinomas, 4 were associated with t(Xp-11.2), 3 were of papillary type II, 1 was papillary type I, 1 was clear cell type, and 1 was unclassified. Five-year overall survival for Wilms tumor was 63% (43% for anaplastic tumors), significantly lower than reported overall survival for all pediatric Wilms tumors. Only 40% of patients with renal cell carcinoma survived, and all patients with other tumors died.
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Affiliation(s)
- Sergey D Popov
- Department Paediatric Oncology, The Institute of Cancer Research, London, UK.
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35
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Fall B, Diao B, Sow Y, Sarr A, Fall PA, Ndoye AK, Diagne BA. [Renal cell carcinoma in children: Report of a case with lymph node involvement]. Arch Pediatr 2011; 18:537-9. [PMID: 21458970 DOI: 10.1016/j.arcped.2011.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 03/19/2010] [Accepted: 02/15/2011] [Indexed: 10/28/2022]
Abstract
Renal cell carcinoma (RCC) in children is rare. This entity has different clinical and biological presentation characteristics from adult RCC. In contrast to Wilms tumor, the efficacy of chemotherapy and radiation therapy in pediatric RCC remains uncertain. Debate continues on the importance of lymph node dissection. The authors present a case of RCC with lymph node involvement in a 12-year-old boy. The treatment was radical nephrectomy and a limited lymphadenectomy. No adjuvant therapy was given. After 13 months of follow-up, there is no evidence of recurrence. This case shows that lymph node involvement (in the absence of distant metastases) is not associated with a poor prognosis in pediatric RCC and that lymphadenectomy in lymph node-positive cases is important.
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Affiliation(s)
- B Fall
- Service d'urologie-andrologie, CHU Aristide-Le-Dantec, avenue Pasteur, BP 35354 Dakar colobane, Sénégal
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Spreafico F, Collini P, Terenziani M, Marchianò A, Piva L. Renal cell carcinoma in children and adolescents. Expert Rev Anticancer Ther 2011; 10:1967-78. [PMID: 21110762 DOI: 10.1586/era.10.188] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although rare in children and adolescents, renal cell carcinomas (RCCs) raise important questions concerning the best treatment approach and accurate pathologic classification. The differences emerging between childhood and adulthood RCC probably prevent any direct generalized application of therapies to children that are validated for adults. The translocation type of RCC, which forms a distinct category characterized by translocations involving Xp11.2 or, less frequently, 6p21, has recently emerged as the predominant type of RCC in children and adolescents, whereas it is rarely diagnosed in adults. This new finding emphasizes how important it is to prospectively classify RCCs in children with standardized 'modern' diagnoses. The standard cornerstone of therapy for RCC in children and adolescents remains radical nephrectomy. Nephron-sparing surgery is currently recommended in adults for selected small-volume tumors, but additional data are needed before this experience can be extensively transferred to the pediatric population. The therapeutic value of complete retroperitoneal lymph node dissection is still controversial, especially in patients without suspected nodal involvement, be they adults or children. The backbone of systemic therapies for adult RCC has recently been changed by the introduction of drugs designed to target tumor-related angiogenesis and signal transduction. It is worth noting that the largest clinical efficacy trials on targeted molecules have been conducted on clear-cell RCC. While targeted drugs have become the standard of care for adult metastatic RCC, there are currently no published reports on their role in children, and their use should be considered for patients with unresectable metastatic or advanced-stage RCC. On the other hand, the utility of targeted therapies in the adjuvant setting remains to be seen for both adults and children.
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Chen CJ, Hsu HT, Lin MT, Pintye M, Chen JR. Renal Cell Carcinoma with t(X;17)(p11.2;q25) in a 5-year-old Taiwanese Boy. A Case Report and Review of the Literature. Pathol Oncol Res 2011; 18:111-6. [DOI: 10.1007/s12253-010-9353-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 12/17/2010] [Indexed: 10/18/2022]
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Mir MC, Trilla E, de Torres IM, Panizo A, Zlotta AR, Van Rhijn B, Morote J. Altered transcription factor E3 expression in unclassified adult renal cell carcinoma indicates adverse pathological features and poor outcome. BJU Int 2010; 108:E71-6. [PMID: 21070573 DOI: 10.1111/j.1464-410x.2010.09818.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the clinical and pathologic features and the prognostic relevance of unclassified RCC with -TFE3 over-expression in our adult series. Recent studies suggest that renal cell carcinomas (RCCs) associated with the newly recognized Xp11.2 translocation (transcription factor E3 [TFE3] gene fusions) can be found among adults with RCC showing a very aggressive disease-course. MATERIAL AND METHODS We evaluated tumour specimens from 25 patients with unclassified RCC morphology out of 298 RCCs in the last 12 years in a tertiary academic centre. Immunohistochemistry was performed using monoclonal antibody for TFE3 C-terminal section, taking nuclear label into consideration. RT-PCR technique was performed for ASPL-TFE3 gene fusion on two tumours with available frozen tissue. RESULTS Of the 25 cases analyzed, 8 (32%) showed positivity for TFE3 and 17 were negative for TFE3 staining. Two tumors with ASPL-TFE3 gene fusion also showed TFE3 over-expression. Fifty percent of the positive patients had lymph node metastatic disease, whereas only one TFE3-negative patient (5.8%) showed evidence of lymph node spread and cava thrombus at diagnosis. Of the TFE3-positive patients, three had a vena cava thrombus (37.5%). Seven of the eight positive cases (87.5%) were diagnosed with a high Fuhrman grade (III/IV). In comparison, five of 17 (29.4%) TFE3-negative patients had a high Fuhrman grade. Five of eight TFE3-positive patients relapsed rapidly at 3 month follow-up; conversely none of the negative cases relapsed. At 36-month mean follow-up, 5-year cancer-specific survival was 15.6% for TFE3-positive patients and 87.5% for TFE3-negative patients (P < 0.001). CONCLUSION Patients with unclassified RCC and TFE3 positivity have a grim prognosis due to their advanced stage at presentation and aggressive biologic features compared with the TFE3-negative unclassified RCC cases.
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Morabito RA, Talug C, Zaslau S, Kandzari S. Asymptomatic Advanced Pediatric Papillary Renal Cell Carcinoma Presenting as a Pulmonary Embolus. Urology 2010; 76:153-5. [DOI: 10.1016/j.urology.2009.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 09/03/2009] [Accepted: 09/05/2009] [Indexed: 10/20/2022]
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40
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Baek M, Jung JY, Kim JJ, Park KH, Ryu DS. Characteristics and clinical outcomes of renal cell carcinoma in children: A single center experience. Int J Urol 2010; 17:737-40. [DOI: 10.1111/j.1442-2042.2010.02588.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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Driss M, Boukadi A, Charfi L, Douira W, Mrad K, Bellagha I, Chaouachi B, Ben Romdhane K. Renal cell carcinoma associated with Xp11.2 translocation arising in a horseshoe kidney. Pathology 2010; 41:587-90. [PMID: 19900111 DOI: 10.1080/00313020903071496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Helmy T, Sarhan O, Sarhan M, El-Baz M, Dawaba M, Ghali A. Renal cell carcinoma in children: single-center experience. J Pediatr Surg 2009; 44:1750-3. [PMID: 19735820 DOI: 10.1016/j.jpedsurg.2009.02.073] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 02/13/2009] [Accepted: 02/13/2009] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of the study was to report the experience with renal cell carcinoma (RCC) in children. MATERIALS AND METHODS We conducted a retrospective study on renal adenocarcinoma cases treated in our center between 1993 and 2008. The age limit was established at 15 years. We collected data on personal history, diagnostic age, sex, clinical presentation, tumor laterality, diagnostic procedure, and tumor stage according to TNM classification proposed by the International Union Against Cancer (2002), surgical technique, pathologic subtype, and outcome. RESULTS Six children were included in this study (4 girls and 2 boys) with a mean age of 9.5 years (range, 4-14 years). Tumor affected the right side in 4 patients and the left side in 2. Follow-up ranged from 9 to 140 months (mean, 85). Two patients were diagnosed as stage T1aN0M0, another was T1bN2M0, and 2 were T2N0M0, whereas the last one was T3N2M0. Radical nephrectomy was performed in 5 patients, whereas partial nephrectomy was adopted in one patient. The most common histologic subtype was translocation morphology RCC. One patient had local recurrence, whereas the other 5 are currently disease-free. CONCLUSION Renal cell carcinoma is a rare histologic type of tumor in children, with certain features that differ from those in adults. In general, RCC in children tends to present later than Wilms' tumor and is usually associated with signs and/or symptoms of disease. In localized cases, the treatment of choice is radical nephrectomy.
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Affiliation(s)
- Tamer Helmy
- Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt
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43
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Sausville JE, Hernandez DJ, Argani P, Gearhart JP. Pediatric renal cell carcinoma. J Pediatr Urol 2009; 5:308-14. [PMID: 19443274 DOI: 10.1016/j.jpurol.2009.04.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Accepted: 04/02/2009] [Indexed: 12/01/2022]
Abstract
Renal cell carcinoma (RCC) comprises about 5% of pediatric renal neoplasms. It has been recognized as a second malignancy in multiple reports. It is generally symptomatic at diagnosis, and most children with RCC present with more locally advanced disease than do adults. Contemporary investigation of pediatric RCC has demonstrated that a large percentage of these tumors bear cytogenetic translocations involving the MiT family of transcription factors. Surgical therapy for these children resembles operative intervention for adult RCC, though debate continues about the precise role of lymph node dissection. There are no adequately powered studies to support conclusions about adjuvant or neoadjuvant chemotherapy for children with RCC. This may be ameliorated by a multi-institutional protocol which is enrolling patients.
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Affiliation(s)
- Justin E Sausville
- James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287, USA.
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44
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Grabowski J, Silberstein J, Saltzstein SL, Saenz N. Renal tumors in the second decade of life: results from the California Cancer Registry. J Pediatr Surg 2009; 44:1148-51. [PMID: 19524731 DOI: 10.1016/j.jpedsurg.2009.02.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 02/17/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND Renal tumors are rare in adolescents and young adults. The aim of this study was to characterize the histologic condition, epidemiology, and survival of renal tumors in patients aged 11 to 20 years old using a large, population-based database. METHODS The California Cancer Registry was reviewed from the years 1988 to 2004. All renal tumors in patients aged 11 to 20 years old were identified. The data were analyzed with relation to patient age, sex and ethnicity, tumor histologic examination, and actuarial mortality rates. RESULTS Seventy-seven primary renal malignancies were identified. Thirty-nine (51%) were renal cell carcinoma, 23 (30%) were Wilms' tumor, and 15 (20%) were other tumor types. The mean age of the patients with renal cell carcinoma was 16.7 years old, which was significantly older than the Wilms' tumor patients (13.9 years; P < .01). The 5-year cumulative survival rate of patients with renal cell carcinoma was 54%, which was worse than that of Wilms' tumor patients (77%). CONCLUSION Primary renal malignancies are uncommon in the second decade of life. The most common tumor type in this age-group is renal cell carcinoma followed by Wilms' tumor. Patients with renal cell carcinoma tend to be older and have a lower survival than patients with other kidney tumors.
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Affiliation(s)
- Julia Grabowski
- Department of Surgery, University of California at San Diego, San Diego, CA 92013, USA.
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45
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Silberstein J, Grabowski J, Saltzstein SL, Kane CJ. Renal cell carcinoma in the pediatric population: Results from the California Cancer Registry. Pediatr Blood Cancer 2009; 52:237-41. [PMID: 18937317 DOI: 10.1002/pbc.21779] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Renal cell carcinoma (RCC) is a rare disease in children and adolescents. This study aimed to review epidemiologic characteristics and survival for pediatric RCC patients using a large, population-based database. PROCEDURE The California Cancer Registry (CCR) was reviewed from 1988 to 2004. All cases of RCC in patients younger than 21 years were identified and annual age-adjusted incidence rates were determined for the overall population and subdivided by ethnicity. Tumors were classified by stage and grade, and actuarial mortality rates were calculated. RESULTS From 1988 to 2004, 43 cases of RCC were identified in patients younger than 21 years, accounting for 4.3% of all renal tumors in this age group. The overall annual age-adjusted incidence was 0.01/100,000 with the tumor more common in non-Hispanic blacks (0.03/100,000) compared to non-Hispanic whites (0.01/100,000), Hispanics (<0.01/100,000), and non-Hispanic Asians/Pacific Islanders (<0.01/100,000). The mean age at presentation was 15.4 years (SD 4.03, SE 0.615). RCC was identified more frequently in females (58.14%). At the time of presentation, 53.49% of tumors were localized, 20.93% were regionally advanced, and 25.58% were metastatic. The observed actuarial survival at 5 and 10 years was 61% (+/-15.7%). CONCLUSION Pediatric RCC is an uncommon and aggressive tumor that occurs most frequently in children in the second decade of life, more often in females and blacks. The epidemiological characteristics of this tumor differ from adult RCC and Wilms tumor, suggesting its distinctive biology and potential need for alternative treatment strategies.
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Affiliation(s)
- Jonathan Silberstein
- Division of Urology, Department of Surgery, University of California, San Diego, Medical Center, San Diego, California, USA.
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46
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Lee SH, Noh SH, Kim SY, Jang KY, Hwang PH. Hand-Foot syndrome induced by sorafenib, a multitargeted tyrosine kinase inhibitor, in a patient with advanced renal cell carcinoma. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.1.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Seung Hyun Lee
- Department of Pediatrics, Chonbuk National University, Jeonju, Korea
| | - Sung Hun Noh
- Department of Pediatrics, Chonbuk National University, Jeonju, Korea
| | - Sun Young Kim
- Department of Pediatrics, Chonbuk National University, Jeonju, Korea
| | - Kyu Yun Jang
- Department of Pathology, Research Institute of Clinical Medicine School of Medicine, Chonbuk National University, Jeonju, Korea
| | - Pyoung Han Hwang
- Department of Pediatrics, Chonbuk National University, Jeonju, Korea
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Wu A, Kunju LP, Cheng L, Shah RB. Renal cell carcinoma in children and young adults: analysis of clinicopathological, immunohistochemical and molecular characteristics with an emphasis on the spectrum of Xp11.2 translocation-associated and unusual clear cell subtypes. Histopathology 2008; 53:533-44. [DOI: 10.1111/j.1365-2559.2008.03151.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Indolfi P, Bisogno G, Cecchetto G, Spreafico F, De Salvo GL, Collini P, Jenkner A, Inserra A, Schiavetti A, di Martino M, Casale F. Local lymph node involvement in pediatric renal cell carcinoma: a report from the Italian TREP project. Pediatr Blood Cancer 2008; 51:475-8. [PMID: 18561180 DOI: 10.1002/pbc.21652] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND One of the most important adverse prognostic factors for adult renal cell carcinoma (RCC) is the retroperitoneal lymph node involvement. The aim of this article is to study the prognostic significance of local lymph node involvement in pediatric RCC and the role of retroperitoneal lymph node dissection (RLND) at diagnosis. PROCEDURE The series included 16 patients with RCC and lymph nodes involvement registered in the Italian Rare Tumors Pediatric Age (TREP) project, accounting for 26.2% of 61 pediatric RCC observed at AIEOP centers. RESULTS A radical nephrectomy was performed in all cases: at diagnosis in 12 cases, after preoperative chemotherapy (CT) in 4 cases. As a part of the same procedure 9 patients underwent RLND, and 7 received a more limited lymph nodes resection. Five (31.2%) developed disease recurrence 2-34 months after diagnosis (median, 6 months) plus 1 developed progression; 6 patients died, 1 of them from secondary leukemia. Among the nine patients receiving RLND, eight are alive and disease free. This compares with only one patient surviving among the seven receiving a more limited lymph nodes resection. The estimated 25-year PFS and OS rates for all patients were 61.4% (95% CI 33.2-80.5) and 50.8% (95% CI 16.5-77.5), respectively. CONCLUSIONS Lymph node involvement is an unfavorable prognostic factor in children with RCC. RLND appears to be a critical factor to improve the outcome. However, when compared to similar adult patients, the outcome in children appears to be better, suggesting that pediatric RCC, or the host, may be critical differences.
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Affiliation(s)
- Paolo Indolfi
- Pediatric Oncology Service, Pediatric Department, Second University of Napoli, Napoli, Italy
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Raney B, Anderson J, Arndt C, Crist W, Maurer H, Qualman S, Wharam M, Wiener E, Meyer W. Primary renal sarcomas in the Intergroup Rhabdomyosarcoma Study Group (IRSG) experience, 1972-2005: A report from the Children's Oncology Group. Pediatr Blood Cancer 2008; 51:339-43. [PMID: 18523987 PMCID: PMC2803057 DOI: 10.1002/pbc.21639] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
PURPOSE To describe clinical and pathologic characteristics and outcome of patients with renal sarcomas. PATIENTS/METHODS The IRSG database includes newly diagnosed patients <21 years old with rhabdomyosarcoma (RMS) or undifferentiated sarcoma (UDS). We identified patients with renal sarcoma and reviewed their charts. RESULTS Ten of the 5,746 eligible IRSG patients enrolled from 1972 to 2005 had primary renal embryonal RMS (N = 6) or UDS (N = 4). Anaplasia was present in six (60%) of the tumors. Patients' ages ranged from 2.6 to 17.8 years. Tumor diameters ranged from 7 to 15 cm (median, 12 cm). At diagnosis, seven patients had localized disease: four underwent complete removal of tumor (Group I), two had microscopic residual (Group II), and one had gross residual tumor (Group III). Three patients had distant metastases (Group IV) in lungs and bone. Nine patients received vincristine, actinomycin D and cyclophosphamide (VAC). Two Group I patients received no radiation therapy (XRT); others received XRT to the primary tumor and to some metastatic sites. Nine patients achieved complete disappearance of tumor, six due to the initial operation. Tumors recurred in lung (N = 2) or brain (N = 1) in Group IV patients; each died within 16 months. The Group III patient died of Aspergillus pneumonia. The six Group I and II patients survive, continuously disease-free, at 2.7-17.3 years (median, 4.7 years). CONCLUSIONS Patients with renal sarcomas often present with large tumors, many of them containing anaplastic features. Removing all gross disease at diagnosis, if feasible, is a critical component of treatment to curing patients with renal sarcoma.
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Affiliation(s)
- Beverly Raney
- Children's Cancer Hospital and Division of Pediatrics, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
| | - James Anderson
- The Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, NE
| | - Carola Arndt
- The Division of Pediatric Hematology/Oncology, The Mayo Clinic, Rochester, MN
| | - Willam Crist
- The Office of the Dean, University of Missouri School of Medicine, Columbia, MO
| | - Harold Maurer
- The Office of the Chancellor, University of Nebraska Medical Center, Omaha, NE
| | - Stephen Qualman
- Department of Laboratory Medicine, Columbus Children’s Hospital, Columbus, OH
| | - Moody Wharam
- The Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medical School, Baltimore, MD
| | - Eugene Wiener
- Department of Pediatric Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - William Meyer
- Department of Pediatric Hematology/Oncology, University of Oklahoma Health Science Center, Oklahoma City, OK
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Pediatric renal adenocarcinoma: a review of our series. Urology 2008; 72:790-3. [PMID: 18502480 DOI: 10.1016/j.urology.2008.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Revised: 03/10/2008] [Accepted: 03/21/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To report our experience with pediatric renal adenocarcinoma. METHODS We conducted a retrospective review of renal adenocarcinoma cases from 1971 to 2006. RESULTS We treated 154 patients with renal tumor, 4 (2.6%) of whom had adenocarcinoma. The mean age of presentation was 8.5 years (range, 2-15 years). Three patients were female and 1 was male. The most common histologic subtype was clear cell carcinoma. Three patients were diagnosed as stage IIIB and one as stage II, according to Robson's classification. All patients were treated with radical nephroureterectomy. One patient died of disease and the other 3 are currently disease-free. CONCLUSIONS Adenocarcinoma is an uncommon histopathologic type of pediatric renal tumor. In patients with hematuria and abdominal or flank pain, we should consider this tumor as a possible diagnosis.
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