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Park S, Lee HY, Lee S. Role of F-18 FDG PET/CT in the follow-up of asymptomatic renal cell carcinoma patients for postoperative surveillance: based on conditional survival analysis. J Cancer Res Clin Oncol 2021; 148:215-224. [PMID: 34106327 DOI: 10.1007/s00432-021-03688-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/05/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study investigated the clinical usefulness of F-18 fluorodeoxylucose (FDG) positron emission tomography/computed tomography (PET/CT) for postoperative surveillance in the RCC patients in terms of detectability of recurrence and radiation exposure. METHODS Three-hundred-and-forty- three RCC patients who underwent surgery and postoperative surveillance were retrospectively included. Conditional recurrent free survival (CRFS) was investigated and diagnostic performance of conventional imaging (CI) which include abdominopelvic CT or/and chest CT was compared to the FDG PET/CT. RESULTS At a median follow-up of 4.3 years (0.5-13.0 years), thirty-nine patients (11.4%) developed recurrence. CRFS of the patients increased over time with greater increment in advanced stage. The sensitivity, specificity, positive-predictive value, negative-predictive value, and accuracy of FDG PET/CT were 92.3%, 97%, 80%, 99.0%, and 96.5% in detecting recurrence, while those values for CI were 89.7%, 97.7%, 83.3%, 98.7%, and 96.8%, respectively. There were no significant differences in these values between FDG PET/CT and CI (McNemar test, p = 0.581). The average radiation dose from FDG PET/CT was around 16.9 ± 3.08 mSv at each follow-up time point. For early stage patients, the average radiation dose from CI was around 26.5 ± 8.57 mSv at each follow-up time point, while this was about 33.0 ± 9.76 mSv for advanced stage patients. CONCLUSION FDG PET/CT exhibited good diagnostic performance in asymptomatic RCC patients after surgery, of a level comparable to that of CI, but with a lower radiation dose.
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Affiliation(s)
- Sohyun Park
- Department of Nuclear Medicine, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
- Division of Convergence Technology, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, 173-82, Gumiro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Sangchul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
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2
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Canil C, Kapoor A, Basappa NS, Bjarnason G, Bossé D, Dudani S, Graham J, Gray S, Hansen AR, Heng DY, Karakiewicz PI, Kollmannsberger C, Lalani AKA, North SA, Patenaude F, Soulières D, Thana M, Winquist E, Wood LA, Reaume MN, Maloni R, Hotte SJ. Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021. Can Urol Assoc J 2021; 15:84-97. [PMID: 33830005 PMCID: PMC8021420 DOI: 10.5489/cuaj.7245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Christina Canil
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON, Canada
| | - Anil Kapoor
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Naveen S. Basappa
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - Georg Bjarnason
- Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Dominick Bossé
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON, Canada
| | - Shaan Dudani
- William Osler Health System, Brampton, ON, Canada
| | | | - Samantha Gray
- Department of Oncology, Dalhousie University, Saint John Regional Hospital, St. John, NB, Canada
| | - Aaron R. Hansen
- Department of Oncology, Princess Margaret Cancer Centre, Toronto ON, Canada
| | - Daniel Y.C. Heng
- Department of Medical Oncology, University of Calgary and Tom Baker Cancer Centre, Calgary AB, Canada
| | - Pierre I. Karakiewicz
- Department of Surgery, Le Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Christian Kollmannsberger
- Division of Medical Oncology, British Columbia Cancer Agency-Vancouver Cancer Centre, and the University of British Columbia, Vancouver, BC, Canada
| | | | - Scott A. North
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - François Patenaude
- Department of Medicine, Hematology Service and Department of Oncology, Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, QC, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Le Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Myuran Thana
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | | | - Lori A. Wood
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - M. Neil Reaume
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON, Canada
| | - Ranjena Maloni
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
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3
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Hotte SJ, Kapoor A, Basappa NS, Bjarnason G, Canil C, Conter HJ, Czaykowski P, Graham J, Gray S, Heng DYC, Karakiewicz PI, Kollmannsberger C, Lalani AKA, North SA, Patenaude F, Soulières D, Violette P, Winquist E, Wood LA, Dudani S, Maloni R, Reaume MN. Management of Advanced Kidney Cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2019. Can Urol Assoc J 2019; 13:343-354. [PMID: 31603413 DOI: 10.5489/cuaj.6256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Anil Kapoor
- Urologic Research Center for Research & Innovation, McMaster University, Hamilton, ON, Canada.,The Kidney Cancer Research Network of Canada, Toronto, ON, Canada
| | - Naveen S Basappa
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - Georg Bjarnason
- Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, The Ottawa Hospital Cancer Center and the University of Ottawa, Ottawa, ON, Canada
| | | | | | | | - Samantha Gray
- Department of Oncology, Dalhousie University, Saint John Regional Hospital, St. John, NB, Canada
| | - Daniel Y C Heng
- Department of Medical Oncology, University of Calgary and Tom Baker Cancer Center, Calgary AB, Canada
| | - Pierre I Karakiewicz
- Department of Surgery, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Christian Kollmannsberger
- Division of Medical Oncology, British Columbia Cancer Agency-Vancouver Cancer Center, and the University of British Columbia, Vancouver, BC, Canada
| | | | - Scott A North
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - François Patenaude
- Department of Medicine, Hematology Service and Department of Oncology, Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, QC, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Phillippe Violette
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | | | - Lori A Wood
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - Shaan Dudani
- Department of Medical Oncology, University of Calgary and Tom Baker Cancer Center, Calgary AB, Canada
| | - Ranjena Maloni
- The Kidney Cancer Research Network of Canada, Toronto, ON, Canada
| | - M Neil Reaume
- Division of Medical Oncology, The Ottawa Hospital Cancer Center and the University of Ottawa, Ottawa, ON, Canada
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4
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Should We Separate the Pulmonary Surveillance Protocol for Postsurgical T1a and T1b Renal Cell Carcinoma? A Multicenter Database Analysis. Urology 2018; 122:127-132. [PMID: 30205104 DOI: 10.1016/j.urology.2018.08.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the incidence of pulmonary metastases (PM) and the utility of the surveillance chest radiography (CXR) in detecting PM after curative treatment to better define surveillance recommendations for T1a and T1b renal cell carcinoma. MATERIALS AND METHODS A retrospective review of a multi-institutional database was performed to include patients with renal masses treated with partial nephrectomy or radical nephrectomy. Patients were excluded for ≥T2 disease, benign pathology, and metastases. The primary outcome was the incidence of asymptomatic pulmonary lesion concerning for PM detected by CXR within 3 years. RESULTS Five hundred sixty-eight patients met criteria of which 384 had T1a and 184 had T1b at a mean follow-up of 45 and 43 months, respectively. Patients averaged 2.96 and 2.99 CXRs for T1a and T1b with 46.8% having surveillance beyond 3 years. Indeterminate lesions were found in 5.7% (22) of T1a and 5.4% (10) in T1b of which 0.01% (2) and 1.1% (2) were confirmed PM by chest computed tomography and biopsy. Three-year CXR surveillance period detected asymptomatic PM in zero and two patients for T1a and T1b, respectively. High risk pathological features were not present in patients with PM. There was no difference in the incidence PM for patients undergoing partial nephrectomy (3/290) or radical nephrectomy (1/278) (P = .62). CONCLUSION Our review suggests that post-treatment pulmonary surveillance should be reserved for T1b and may not be required for T1a given the low yield and false positives of CXR leading to unnecessary radiation and potential biopsies.
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5
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Sharafeldeen M, Kotb A. Unusual presentation of late recurrence renal malignancy. AFRICAN JOURNAL OF UROLOGY 2018. [DOI: 10.1016/j.afju.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kashan M, Ghanaat M, Hötker AM, Duzgol C, Sanchez A, DiNatale RG, Blum KA, Becerra MF, Manley BJ, Casuscelli J, Chiok M, Coleman JA, Russo P, Tickoo SK, Akin O, Hakimi AA. Cystic Renal Cell Carcinoma: A Report on Outcomes of Surgery and Active Surveillance in Patients Retrospectively Identified on Pretreatment Imaging. J Urol 2018; 200:275-282. [PMID: 29496470 DOI: 10.1016/j.juro.2018.02.3087] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE We evaluated the outcomes of surgical intervention and active surveillance in patients diagnosed with cystic renal cell carcinoma at our hypothesized radiological cutoff of greater than 50% cystic. MATERIALS AND METHODS We identified all 430 patients with a pathologically confirmed cystic renal mass that fit our criteria from 2000 to 2015. The 292 patients with a lack of computerized tomography, tumors less than 50% cystic on imaging, multifocal tumors and prior renal cell carcinoma were excluded from study. Patients were stratified into benign or malignant subgroups, and radiological, clinicopathological and oncologic features were determined. Univariate and multivariate associations between clinicoradiological parameters in each group were analyzed. We similarly reviewed the records of a separate cohort of patients treated with active surveillance for cystic renal cell carcinoma. RESULTS Of the 138 identified cases of cystic renal cell carcinoma 102 (73.9%) were renal cell carcinoma and 36 (26.1%) were benign masses. Of the tumors 77.5% were Fuhrman grade 1-2, 83.4% were stage pT2 or less and 65.9% showed clear cell histology. On univariate analysis male gender, a solid component and increasing Bosniak classification were significant for malignancy. In a separate cohort we identified 38 patients on active surveillance. The growth rate was 1.0 mm per year overall and 2.3 mm per year for the solid component. At a median followup of more than 4 years in all cohorts there was no evidence of recurrence or metastasis of cystic renal cell carcinoma. CONCLUSIONS Patients with unifocal cystic renal cell carcinoma evaluated using a standardized radiological threshold of greater than 50% cystic had an excellent prognosis on active surveillance and after surgical resection.
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Affiliation(s)
- Mahyar Kashan
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mazyar Ghanaat
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andreas M Hötker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cihan Duzgol
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alejandro Sanchez
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Renzo G DiNatale
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kyle A Blum
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maria F Becerra
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Brandon J Manley
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jozefina Casuscelli
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - Michael Chiok
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
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7
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Dragomir A, Aprikian A, Kapoor A, Finelli A, Pouliot F, Rendon R, Black PC, Moore R, Breau RH, Kawakami J, Drachenberg D, Lattouf JB, Tanguay S. Follow-up imaging after nephrectomy for cancer in Canada: urologists' compliance with guidelines. An observational study. CMAJ Open 2017; 5:E834-E841. [PMID: 29229610 PMCID: PMC5741415 DOI: 10.9778/cmajo.20170005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Surgical tumour removal remains the preferred treatment for most patients with renal cell carcinoma, and many medical associations have proposed guidelines for the optimal surveillance of patients following surgery. This study evaluated the adherence of Canadian urologists to the follow-up guidelines proposed by the Canadian Urological Association (CUA) in 2009. METHODS The study cohort was identified from the Canadian Kidney Cancer Information System, a prospectively populated database from 15 academic institutions in 6 Canadian provinces: British Colombia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. A total of 1982 patients who underwent radical or partial nephrectomy for stage pT1-3N0M0 renal cancer between January 2011 and June 2016 were included in the cohort. Numbers of abdominal and chest imaging tests performed during the follow-up period were captured and compared with the 2009 CUA guidelines. The level of compliance was measured by means of weighted κ and Pearson correlation statistics. Multivariate logistic regression was used to evaluate factors associated with noncompliance (under- or overtesting) in the postoperative surveillance period. RESULTS Of the 1982 patients, 1380 had stage pT1 disease, 164 had stage pT2 disease, and 438 had stage pT3 disease. There was incongruent adherence to the CUA surveillance guidelines, with a ratio of observed to recommended tests of 0.71 and 2.27 for chest and abdominal imaging, respectively. Overall, moderate correlation between observed and recommended tests was observed, with the highest value found for abdominal imaging in the pT3 group (κ = 0.59 [95% confidence interval 0.52-0.66]). Patients who underwent radical nephrectomy and those who presented with a higher stage of the disease were less likely to receive fewer chest imaging tests than recommended, and those with stage pT2 disease, those with stage pT3 disease, those with conventional clear cell renal cell carcinoma and those with a low-risk histologic type had an increased risk of undertesting. INTERPRETATION In the 6 Canadian provinces, there are large differences between guidelines and clinical practice in imaging surveillance after nephrectomy for renal cell carcinoma. Better adherence to clinical guidelines could improve optimization of health care services.
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Affiliation(s)
- Alice Dragomir
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Armen Aprikian
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Anil Kapoor
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Antonio Finelli
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Frédéric Pouliot
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Ricardo Rendon
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Peter C Black
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Ronald Moore
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Rodney H Breau
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Jun Kawakami
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Darrell Drachenberg
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Jean-Baptiste Lattouf
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
| | - Simon Tanguay
- Affiliations: McGill University and McGill University Health Centre (Dragomir, Aprikian, Tanguay), Montréal, Que; McMaster University (Kapoor), Hamilton, Ont.; Princess Margaret Cancer Centre and University of Toronto (Finelli), Toronto, Ont.; Université Laval (Pouliot), Québec, Que.; Dalhousie University and Queen Elizabeth II Health Sciences Centre (Rendon), Halifax, NS; University of British Columbia (Black), Vancouver, BC; University of Alberta (Moore), Edmonton, Alta.; University of Ottawa (Breau), Ottawa, Ont.; University of Alberta (Kawakami), Calgary, Alta.; University of Manitoba (Drachenberg), Winnipeg, Man.; University of Montréal (Lattouf), Montréal, Que
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8
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Reaume MN, Basappa NS, Wood L, Kapoor A, Bjarnason GA, Blais N, Breau RH, Canil C, Cheung P, Conter HJ, Hotte SJ, Jeldres C, Jewett MAS, Karakiewicz PI, Kollmannsberger C, Patenaude F, So A, Soulières D, Venner P, Violette P, Zalewski P, Chappell H, North SA. Management of advanced kidney cancer: Canadian Kidney Cancer Forum (CKCF) consensus update 2017. Can Urol Assoc J 2017; 11:310-320. [PMID: 29382441 DOI: 10.5489/cuaj.4769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- M Neil Reaume
- Division of Medical Oncology, Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON, Canada
| | - Naveen S Basappa
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - Lori Wood
- Department of Medicine and Urology, Dalhousie University, Halifax, NS, Canada
| | - Anil Kapoor
- Division of Urology, McMaster University, Hamilton, ON, Canada.,The Kidney Cancer Research Network of Canada, Toronto, ON, Canada
| | - Georg A Bjarnason
- Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Normand Blais
- Division of Medical Oncology/Hematology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Rodney H Breau
- Clinical Epidemiology Program and Division of Urology, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON, Canada
| | - Patrick Cheung
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
| | | | | | - Claudio Jeldres
- Centre hospitalier de l'Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Pierre I Karakiewicz
- Service d'urologie, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Christian Kollmannsberger
- Division of Medical Oncology, British Columbia Cancer Agency-Vancouver Cancer Centre, and University of British Columbia, Vancouver, BC, Canada
| | - Francois Patenaude
- Department of Medicine, Hematology Service and Department of Oncology, Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, QC, Canada
| | - Alan So
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Peter Venner
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | | | - Pawel Zalewski
- R.S. McLaughlin Durham Regional Cancer Centre, Oshawa, ON, Canada
| | | | - Scott A North
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
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9
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Srinivas S, Stein D, Teltsch DY, Tao S, Cisar L, Ramaswamy K. Real-world chart review study of adverse events management in patients taking tyrosine kinase inhibitors to treat metastatic renal cell carcinoma. J Oncol Pharm Pract 2017; 24:574-583. [PMID: 28732453 DOI: 10.1177/1078155217719583] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose is to describe management of adverse events of special interest across tyrosine kinase inhibitors approved for metastatic renal cell carcinoma. METHODS We conducted a retrospective chart review in metastatic renal cell carcinoma patients initiating tyrosine kinase inhibitor monotherapy between 15 November 2010 and 15 November 2013, and experiencing ≥ 1 adverse events of special interest (diarrhea, fatigue, hand-foot syndrome, hypertension, or stomatitis/mucositis) within 3 months of initiation. Demographics, medical history, treatment regimens, and adverse events of special interest management data for 3.5 months postonset were collected. RESULTS In 220 charts from 27 centers, tyrosine kinase inhibitors prescribed included sunitinib (55%), pazopanib (27%), axitinib (9%), and sorafenib (8%). During the study period, patients experienced 376 adverse events of special interest (13% serious). Fatigue was most common (62% of patients), followed by hypertension (37%), diarrhea (30%), stomatitis/mucositis (29%), and hand-foot syndrome (12%). Over half (56%) the adverse events of special interest were resolved or resolving. Treatment discontinuation due to adverse events of special interest occurred in 15% of patients. Prophylaxis was rarely provided (8%), whereas 59% of patients received adverse events of special interest treatment (pharmacologic (55%) and/or nonpharmacologic (7%)), 27% received tyrosine kinase inhibitor dose management, 23% received both adverse events of special interest treatment and dose management, and 31% received neither. Hypertension was the most treated (72% of all events), and fatigue was the least treated (9%); only 4% of patients received pharmacologic treatment for fatigue. CONCLUSIONS Most adverse events of special interest were nonserious and more than half of the patients received pharmacologic and/or nonpharmacologic treatment. Fatigue was the most common yet least frequently treated adverse event of special interest, and few patients received prophylaxis or nonpharmacologic treatment. More emphasis on treatment and prophylaxis options for bothersome adverse events is warranted.
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Affiliation(s)
- Sandy Srinivas
- 1 Division of Medical Oncology, Stanford University Medical Center, USA
| | - Dara Stein
- 2 Safety, Epidemiology, Registries, and Risk Management (SERRM), United BioSource Corporation, Canada
| | | | - Sunning Tao
- 2 Safety, Epidemiology, Registries, and Risk Management (SERRM), United BioSource Corporation, Canada
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10
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Williamson TJ, Pearson JR, Ischia J, Bolton DM, Lawrentschuk N. Guideline of guidelines: follow-up after nephrectomy for renal cell carcinoma. BJU Int 2016; 117:555-62. [PMID: 26617405 DOI: 10.1111/bju.13384] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/20/2015] [Indexed: 12/22/2022]
Abstract
The purpose of this article was to review and compare the international guidelines and surveillance protocols for post-nephrectomy renal cell carcinoma (RCC). PubMed database searches were conducted, according to the PRISMA statement for reporting systematic reviews, to identify current international surveillance guidelines and surveillance protocols for surgically treated and clinically localized RCC. A total of 17 articles were reviewed. These included three articles on urological guidelines, three on oncological guidelines and 11 on proposed strategies. Guidelines and strategies varied significantly in relation to follow-up, specifically with regard to the frequency and timing of radiological imaging. Although there is currently no consensus within the literature regarding surveillance protocols, various guidelines and strategies have been developed using both patient and tumour characteristics.
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Affiliation(s)
- Timothy J Williamson
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - John R Pearson
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - Joseph Ischia
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - Damien M Bolton
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - Nathan Lawrentschuk
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, Vic., Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.,Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Vic., Australia
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11
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Jewett MAS, Rendon R, Lacombe L, Karakiewicz PI, Tanguay S, Kassouf W, Leveridge M, Cagiannos I, Kapoor A, Pautler S, Drachtenberg D, Moore R, Gleave M, Evans A, Haider M, Finelli A. Canadian guidelines for the management of small renal masses (SRM). Can Urol Assoc J 2015. [PMID: 26225162 DOI: 10.5489/cuaj.2969] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
| | - Ricardo Rendon
- Department of Urology, Dalhousie University, Halifax, NS
| | - Louis Lacombe
- Division of Urology, Université Laval, Quebec City, QC
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC
| | - Simon Tanguay
- Division of Urology, McGill University, Montreal, QC; Division of Urology, University of Ottawa, Ottawa, ON
| | - Wassim Kassouf
- Division of Urology, McGill University, Montreal, QC; Division of Urology, University of Ottawa, Ottawa, ON
| | - Mike Leveridge
- Department of Urology, Queen's University, Kingston General Hospital, Kingston, ON
| | | | - Anil Kapoor
- Division of Urology, McMaster University, Hamilton, ON
| | | | | | - Ronald Moore
- Division of Urology, University of Alberta, Edmonton, AB
| | - Martin Gleave
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC
| | - Andrew Evans
- Department of Pathology and Laboratory, Faculty of Medicine, University of Toronto, Toronto, ON
| | - Massoom Haider
- Department of Medical Imaging, University of Toronto, Toronto, ON
| | - Antonio Finelli
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
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12
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North SA, Basappa N, Basiuk J, Bjarnason G, Breau R, Canil C, Heng D, Jewett MAS, Kapoor A, Kollmannsberger C, Potvin K, Neil Reaume M, Dean Ruether J, Venner P, Wood L. Management of advanced kidney cancer: Canadian Kidney Cancer Forum consensus update. Can Urol Assoc J 2015. [PMID: 26225164 DOI: 10.5489/cuaj.2894] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Scott A North
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB
| | | | - Naveen Basappa
- Department of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB
| | - Joan Basiuk
- Kidney Cancer Research Network of Canada, Toronto, ON
| | - Georg Bjarnason
- Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON
| | - Rodney Breau
- Division of Urology, University of Ottawa, Ottawa, ON; and the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON
| | | | - Daniel Heng
- Department of Medical Oncology, Tom Baker Cancer Center, and the University of Calgary, Calgary, AB
| | - Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
| | - Anil Kapoor
- Division of Urology, McMaster University, Hamilton, ON
| | - Christian Kollmannsberger
- Division of Medical Oncology, British Columbia Cancer Agency-Vancouver Cancer Centre, and the University of British Columbia, Vancouver, BC
| | - Kylea Potvin
- London Regional Cancer Centre, Western University, London, ON
| | - M Neil Reaume
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON
| | - J Dean Ruether
- Department of Medical Oncology, Tom Baker Cancer Center, and the University of Calgary, Calgary, AB
| | - Peter Venner
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB
| | - Lori Wood
- Department of Medicine and Urology, Dalhousie University, Halifax, NS
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13
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Black P. Canadian guidelines for SRMs: How Canadian are they? Can Urol Assoc J 2015; 9:163-213. [PMID: 26225163 PMCID: PMC4479635 DOI: 10.5489/cuaj.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Peter Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC
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14
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Bhatt JR, Finelli A. Landmarks in the diagnosis and treatment of renal cell carcinoma. Nat Rev Urol 2014; 11:517-25. [PMID: 25112856 DOI: 10.1038/nrurol.2014.194] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The most common renal cancer is renal cell carcinoma (RCC), which arises from the renal parenchyma. The global incidence of RCC has increased over the past two decades by 2% per year. RCC is the most lethal of the common urological cancers: despite diagnostic advances, 20-30% of patients present with metastatic disease. A clearer understanding of the genetic basis of RCC has led to immune-based and targeted treatments for this chemoresistant cancer. Despite promising results in advanced disease, overall response rates and durable complete responses are rare. Surgery remains the main treatment modality, especially for organ-confined disease, with a selective role in advanced and metastatic disease. Smaller tumours are increasingly managed with biopsy, minimally invasive interventions and surveillance. The future promises multimodal, integrated and personalized care, with further understanding of the disease leading to new treatment options.
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Affiliation(s)
- Jaimin R Bhatt
- Princess Margaret Cancer Centre, University of Toronto, Division of Urology, 610 University Avenue 3-130, Toronto, ON M5G 2M9, Canada
| | - Antonio Finelli
- Princess Margaret Cancer Centre, University of Toronto, Division of Urology, 610 University Avenue 3-130, Toronto, ON M5G 2M9, Canada
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15
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Rendon RA, Kapoor A, Breau R, Leveridge M, Feifer A, Black PC, So A. Surgical management of renal cell carcinoma: Canadian Kidney Cancer Forum Consensus. Can Urol Assoc J 2014; 8:E398-412. [PMID: 25024794 DOI: 10.5489/cuaj.1894] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Anil Kapoor
- Department of Surgery, Division of Urology, McMaster University, Hamilton, ON
| | - Rodney Breau
- Division of Urology, University of Ottawa, Ottawa, ON
| | - Michael Leveridge
- Departments of Urology and Oncology, Queen's University, Kingston, ON
| | | | - Peter C Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC
| | - Alan So
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC
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16
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North S, Basappa N, Bjarnason G, Blais N, Canil C, Heng D, Knox J, Reaume N, Ruether D, Soulières D, Zalewski P, Black P, Breau RH, Jewett M, Kapoor A, Lattouf JB, Moore R, Rendon R, Todd G, Pituskin E, Gedye C, Wood L. Management of advanced kidney cancer: Canadian Kidney Cancer Forum 2013 Consensus Update: Canadian Kidney Cancer Forum 2013. Can Urol Assoc J 2013; 7:238-43. [PMID: 24032057 DOI: 10.5489/cuaj.536] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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17
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Sejben I, Szabó Z, Lukács N, Loránd M, Sükösd F, Cserni G. Papillary renal cell carcinoma embedded in an oncocytoma: Case report of a rare combined tumour of the kidney. Can Urol Assoc J 2013; 7:E513-6. [PMID: 23914273 DOI: 10.5489/cuaj.414] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
An asymptomatic 1-cm large papillary renal cell carcinoma (RCC) embedded in a 3.5-cm large oncocytoma was diagnosed and removed by right nephrectomy in a 68-year-old male investigated for the abdominal symptoms associated with cholelithiasis. The papillary RCC displayed positive immunohistochemical stainings with cytokeratin 7, alpha-methylacyl-CoA racemase and vimentin and was negative for the E-cadherin and CD117 immunostains, whereas the oncocytoma part showed opposite staining patterns. No gains of chromosomes 7 and 17 or loss of chromosome Y was detected in the papillary carcinoma by fluorescent in situ hybridization with centromeric enumeration probes. This finding is in keeping with the morphologic diagnosis of type 2 papillary RCC reported to have lower rates of these characteristic chromosomal changes. The combination of papillary RCC and oncocytoma, two tumours of different postulated origin, is extremely rare. It may represent a simple coincidence, but 2 previous cases and our current one share a few features, including the intimate embedment of the papillary RCC in the oncocytoma, the small size of the RCC and the old age of the patients. This case raises the point that renal oncocytomas can contain a hidden malignant tumour.
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Affiliation(s)
- István Sejben
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
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