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Lan J, Lan D, Yuan W, Ying Q, He J, Gu Y. Radical nephrectomy for a giant chromophobe renal cell carcinoma diagnosed > 17 years previously: a case report and literature review. Front Oncol 2024; 14:1352689. [PMID: 38634044 PMCID: PMC11021568 DOI: 10.3389/fonc.2024.1352689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024] Open
Abstract
Early diagnosis of renal cell carcinoma relies on imaging tests such as ultrasound, computed tomography, or magnetic resonance imaging. Since surgery is associated with a favorable prognosis, the standard treatment for clinically limited renal cell carcinoma remains surgical resection. Among asymptomatic patients with localized renal cell carcinoma, a small number refuse surgical treatment and survive. We report a case involving a 59-year-old female who underwent a difficult radical nephrectomy 17 years after being diagnosed with malignant tumors due to primary renal cell carcinoma.
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Affiliation(s)
- Jianhua Lan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Dong Lan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Wenqiang Yuan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Qiao Ying
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Jiahong He
- Department of Cardiac and Vascular Surgery, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Yonglin Gu
- Department of Cardiology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
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Duus LA, Junker T, Rasmussen BS, Bojsen JA, Pedersen AL, Anthonsen A, Lund L, Pedersen M, Graumann O. Safety, efficacy, and mid-term oncological outcomes of computed tomography-guided cryoablation of T1 renal cancer. Acta Radiol 2023; 64:814-820. [PMID: 35297745 DOI: 10.1177/02841851221081825] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cryoablation is a promising minimally invasive, nephron-sparing treatment of small renal carcinoma (RCC) in co-morbid patients. PURPOSE To assess the safety, efficacy, and cancer-specific outcomes of computed tomography (CT)-guided cryoablation of stage T1 (RCC). MATERIAL AND METHODS A retrospective evaluation of 122 consecutive patients with 128 tumors treated with cryoablation during 2016-2017. All patients had biopsy-verified T1 RCC. RESULTS Median age was 69 years (IQR=59-76); 69% were male. Median tumor size was 26 mm (± 20-33); 9% were stage T1b. Mean follow-up time was 36.3±12.0 months. In total, 14 (11%) procedures led to complications, of which 4 (3%) were intraoperative, 5 (4%) appeared ≤30 days and 5 (4%) >30 days after treatment. Major complications arose after 4 (3%) procedures. Statistically significant associations were found between major complications and stage T1b (P = 0.039), RENAL score (P = 0.010), and number of needles used in cryoablation (P = 0.004). Residual tumor was detected after 4 (3%) procedures and 5 (4%) tumors had local tumor progression. Of 122 patients, 3 (2%) advanced to metastatic disease. Significant statistical associations were found between local tumor progression and T1b stage tumors and number of needles used in cryoablation (P = 0.05 and P = 0.004, respectively). For patients with T1a tumors, the one- and three-year disease-free survival was 98% and 95%, respectively, and for T1b 100% after one year and 75% after three years. CONCLUSIONS This study showed that cryoablation is a safe and effective treatment of stage T1 RCC and suggests that in selecting candidates for cryoablation of RCC, the tumor characteristics are more critical than patients' baseline health status.
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Affiliation(s)
- Louise A Duus
- Department of Radiology, 11286Odense University Hospital (OUH), Odense C, Denmark.,Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark.,OPEN, Odense Patient data Explorative Network, SDU, Odense C, Denmark
| | - Theresa Junker
- Department of Radiology, 11286Odense University Hospital (OUH), Odense C, Denmark.,Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark.,OPEN, Odense Patient data Explorative Network, SDU, Odense C, Denmark
| | - Benjamin S Rasmussen
- Department of Radiology, 11286Odense University Hospital (OUH), Odense C, Denmark.,Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark
| | - Jonas A Bojsen
- Department of Radiology, 11286Odense University Hospital (OUH), Odense C, Denmark.,Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark
| | - Allan L Pedersen
- Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark
| | - Andrea Anthonsen
- Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark
| | - Lars Lund
- Department of Urology, OUH, Odense C, Denmark.,Institute of Clinical Research, SDU, Odense C, Denmark
| | - Michael Pedersen
- Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark.,Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Ole Graumann
- Department of Radiology, 11286Odense University Hospital (OUH), Odense C, Denmark.,Research and Innovation Unit of Radiology, 6174University of Southern Denmark (SDU), Odense C, Denmark.,OPEN, Odense Patient data Explorative Network, SDU, Odense C, Denmark
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Ameri CA, Pita HR, Vitagliano G, Blas L. Renal tumor growth rate in patients with previously normal CT scan: Analysis of the initial stage of growth. Turk J Urol 2020; 47:9-13. [PMID: 33052828 DOI: 10.5152/tud.2020.20201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Most of the studies regarding natural history of renal masses are based on active surveillance series and suggest that the renal masses have a slow growth rate. Nevertheless, only a few studies report the time between a normal computed tomography (CT) scan to the first detection of a tumor. We aimed to analyze the growth rate in newly diagnosed kidney tumors. MATERIAL AND METHODS We analyzed patients with enhancing renal masses that developed after a normal CT scan, which was performed at most 12 months earlier. Variables examined included patient age, gender, tumor size, volume, tumor linear growth rate (LGR). All cases were surgically treated. Mann-Whitney U test was used to compare variables. A p<0.05 was considered as statistically significant. RESULTS We found 31 patients with 33 lesions. Male to female ratio was 1.58 (19/12). The average age was 59.2 years (standard deviation [SD]±12.1), and the mean tumor size was 4.27 cm (SD±4.3). Tumor LGR was 0.87 cm/month (range: 0.28-1.66) and presumed to be 10.4 cm at 1 year (range: 3.36-19.9). Tumor LGR for time detection at <6 month or ≥6 months were 1.1 cm/month and 0.68 cm/month (range: 0.27-1.08 and 0.88-1.76, respectively; p=0.0004), respectively. Tumor LGRs for low- and high-grade tumors were 0.89 cm/month and 0.83 cm/month (p=0.65), respectively. Median volume was 36.1 cm3 (range: 2.61-143.7), and for low and high grade the median volumes were 27.9 cm3 and 47.6 cm3, respectively (p=0.54). Malignant pathology was present in 93.9 % (31 of 33) of masses (lesions). CONCLUSION We found differences in tumor LGR in tumors detected before and after 6 months. We did not find any correlation between tumor growth rate and Fuhrman grade system, gender, histology, or age. We found the highest LGR published up to date.
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Affiliation(s)
| | | | | | - Leandro Blas
- Hospital Aleman de Buenos Aires, Buenos Aires, Argentina
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Fujimori M, Yamanaka T, Sugino Y, Matsushita N, Sakuma H. Percutaneous Image-guided Thermal Ablation for Renal Cell Carcinoma. INTERVENTIONAL RADIOLOGY 2020; 5:32-42. [PMID: 36284654 PMCID: PMC9550385 DOI: 10.22575/interventionalradiology.2020-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/17/2020] [Indexed: 11/05/2022]
Abstract
Nephrectomy is the gold standard for the treatment of renal cell carcinoma (RCC). However, some patients are not suitable candidates for nephrectomy because of high surgical risk, reduced renal function, or the presence of multiple renal tumors. Percutaneous image-guided thermal ablation, including cryoablation and radiofrequency ablation, is a minimally invasive and highly effective treatment and can be used to treat RCC in patients who are not good candidates for surgery. This article will review percutaneous image-guided thermal ablation for RCC, covering treatment indications, ablation modalities and techniques, oncologic outcomes, and possible complications. In addition, the characteristics of each ablation modality and its comparison with nephrectomy are also presented.
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Affiliation(s)
| | | | - Yuichi Sugino
- Department of Radiology, Mie University School of Medicine
| | | | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine
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Abstract
Objective: To review hot issues and future direction of renal tumor biopsy (RTB) technique. Data Sources: The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015. Study Selection: We included all the relevant articles on RTB technique in English, with no limitation of study design. Results: Computed tomography and ultrasound were usually used for guiding RTB with respective advantages. Core biopsy is more preferred over fine needle aspiration because of superior accuracy. A minimum of two good-quality cores for a single renal tumor is generally accepted. The use of coaxial guide is recommended. For biopsy location, sampling different regions including central and peripheral biopsies are recommended. Conclusion: In spite of some limitations, RTB technique is relatively mature to help optimize the treatment of renal tumors.
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Affiliation(s)
- Lei Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, China
| | - Xue-Song Li
- Department of Urology, Peking University First Hospital, Beijing 100034, China
| | - Li-Qun Zhou
- Department of Urology, Peking University First Hospital, Beijing 100034, China
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High Uric Acid (UA) Negatively Affects Serum Tartrate-Resistant Acid Phosphatase 5b (TRACP 5b) Immunoassay. PLoS One 2016; 11:e0147554. [PMID: 26800211 PMCID: PMC4723035 DOI: 10.1371/journal.pone.0147554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 01/05/2016] [Indexed: 11/30/2022] Open
Abstract
Background Bone metastases often occur in the majority of patients with advanced cancer, such as prostate cancer, lung cancer and breast cancer. Serum tartrate-resistant acid phosphatase 5b (TRACP 5b), a novel bone resorption marker, has been used gradually in the clinics as a specific and sensitive marker of bone resorption for the early diagnosis of cancer patients with bone metastasis. Here, we reported that high concentrations of uric acid (UA) lead to decrease of TRACP 5b levels and determined whether TRACP 5b level was associated with UA in interference experiment. Methods A total of 77 patients with high concentrations of UA and 77 healthy subjects were tested to evaluate the differences in their TRACP 5b levels. Serial dilutions of UA were respectively spiked with a known concentration of TRACP 5b standard sample, then Serum TRACP 5b was detected by using bone TRAP® Assay. A correction equation was set to eliminate UA-derived TRACP 5b false-decrease. The effect of this correction was evaluated in high-UA individuals. Results The average TRACP level of the high-UA individuals (1.47± 0.62 U/L) was significantly lower than that of the healthy subjects (2.62 ± 0.63 U/L) (t-test, p<0.0001). The UA correction equation derived: ΔTRACP 5b = -1.9751lgΔUA + 3.7365 with an R2 = 0.98899. Application of the UA correction equation resulted in a statistically non-significant difference in TRACP 5b values between the healthy subjects and high-UA individuals (p = 0.24). Conclusions High UA concentrations can falsely decrease TRACP 5b levels due to a method-related systematic error. To avoid misdiagnoses or inappropriate therapeutic decisions, increased attention should be paid to UA interference, when TRACP 5b is used for early diagnosis of cancer patients with bone metastasis, evaluation of the aggressiveness of osteosarcoma or prediction of survival in prostate cancer and breast cancer with bone metastases.
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