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Fang K, Liang S, Liu D, Yi Q, Li Y, Zhu R. Hsa_circ_0003596 enhances the development of cell renal clear cell carcinoma through the miR-502-5p/IGF1/PI3K/AKT axis. J Gene Med 2023; 25:e3562. [PMID: 37392008 DOI: 10.1002/jgm.3562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/02/2023] [Accepted: 06/08/2023] [Indexed: 07/02/2023] Open
Abstract
Accumulating research findings have shown that circular RNAs (circRNAs) play an indispensable role in tumorigenesis and tumor progression. The current study aimed to explore the role and modulatory mechanism of hsa_circ_0003596 in clear cell renal cell carcinoma (ccRCC). Quantitative real-time polymerase chain reaction was adopted to detect the expression of hsa_circ_0003596 in ccRCC tissue and cell lines. 5-Ethynyl-2'-deoxyuridine, cell counting kit 8 and the colony formation assay were utilized to assess the proliferation potential of the ccRCC cells. Transwell along with wound healing assays were adopted to quantify infiltration coupled with the migration potential of the cells. The current research study found that the circRNA hsa_circ_0003596 was overexpressed in ccRCC tissue and cell lines. Further, result showed that hsa_circ_0003596 was associated with distant metastasis of renal cancer. Notably, the knockdown of hsa_circ_0003596 can lower the proliferation, infiltration and migration potential of ccRCC cells. The results of in vivo experiments found that the reduction of hsa_circ_0003596 significantly hampered the growth of tumors in mice. In addition, it was evident that hsa_circ_0003596 acts as a "molecular sponge" for miR-502-5p to upregulate the expression of the microRNA-502-5p (miR-502-5p) target insulin-like growth factor 1 (IGF1R). Furthermore, it was found that the phosphatidylinositol 3-kinase (PI3K)/AKT signaling was the downstream cascade of hsa_circ_0003596/miR-502-5p/IGF1R cascade, which is partly responsible for the cancer-promoting effect. Overall, the results of the present study showed that hsa_circ_0003596 facilitated the proliferation, infiltration and migration of ccRCC through the miR-502-5p/IGF1R/PI3K/AKT axis. Therefore, it was evident that hsa_circ_0003596 can serve as a possible biomarker and therapeutic target against ccRCC.
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Affiliation(s)
- Kai Fang
- Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Shengjie Liang
- Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Dong Liu
- Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Qingtong Yi
- Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Yang Li
- Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Rujian Zhu
- Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
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Elias R, Tcheuyap VT, Kaushik AK, Singla N, Gao M, Reig Torras O, Christie A, Mulgaonkar A, Woolford L, Stevens C, Kettimuthu KP, Pavia-Jimenez A, Boroughs LK, Joyce A, Dakanali M, Notgrass H, Margulis V, Cadeddu JA, Pedrosa I, Williams NS, Sun X, DeBerardinis RJ, Öz OK, Zhong H, Seshagiri S, Modrusan Z, Cantarel BL, Kapur P, Brugarolas J. A renal cell carcinoma tumorgraft platform to advance precision medicine. Cell Rep 2021; 37:110055. [PMID: 34818533 PMCID: PMC8762721 DOI: 10.1016/j.celrep.2021.110055] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/10/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022] Open
Abstract
Renal cell carcinoma (RCC) encompasses a heterogenous group of tumors, but representative preclinical models are lacking. We previously showed that patient-derived tumorgraft (TG) models recapitulate the biology and treatment responsiveness. Through systematic orthotopic implantation of tumor samples from 926 ethnically diverse individuals into non-obese diabetic (NOD)/severe combined immunodeficiency (SCID) mice, we generate a resource comprising 172 independently derived, stably engrafted TG lines from 148 individuals. TG lines are characterized histologically and genomically (whole-exome [n = 97] and RNA [n = 102] sequencing). The platform features a variety of histological and oncogenotypes, including TCGA clades further corroborated through orthogonal metabolomic analyses. We illustrate how it enables a deeper understanding of RCC biology; enables the development of tissue- and imaging-based molecular probes; and supports advances in drug development.
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Affiliation(s)
- Roy Elias
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Vanina T Tcheuyap
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Akash K Kaushik
- Howard Hughes Medical Institute and Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nirmish Singla
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ming Gao
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Oscar Reig Torras
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alana Christie
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Biostatistics, Department of Clinical Sciences, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Aditi Mulgaonkar
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Layton Woolford
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christina Stevens
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kavitha Priya Kettimuthu
- Department of Biochemistry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Andrea Pavia-Jimenez
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lindsey K Boroughs
- Howard Hughes Medical Institute and Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Allison Joyce
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marianna Dakanali
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hollis Notgrass
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Vitaly Margulis
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey A Cadeddu
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ivan Pedrosa
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Noelle S Williams
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Bioinformatics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xiankai Sun
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ralph J DeBerardinis
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Howard Hughes Medical Institute and Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Orhan K Öz
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hua Zhong
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Bioinformatics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Somasekar Seshagiri
- Department of Microchemistry, Proteomics, Lipidomics and NGS, Genentech, Inc., South San Francisco, CA, USA
| | - Zora Modrusan
- Department of Microchemistry, Proteomics, Lipidomics and NGS, Genentech, Inc., South San Francisco, CA, USA
| | - Brandi L Cantarel
- Department of Bioinformatics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Payal Kapur
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Brugarolas
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Shi J, Xiong Z, Wang K, Yuan C, Huang Y, Xiao W, Meng X, Chen Z, Lv Q, Miao D, Liang H, Xu T, Xie K, Yang H, Zhang X. HIF2α promotes tumour growth in clear cell renal cell carcinoma by increasing the expression of NUDT1 to reduce oxidative stress. Clin Transl Med 2021; 11:e592. [PMID: 34841698 PMCID: PMC8567048 DOI: 10.1002/ctm2.592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/13/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The key role of hypoxia-inducible factor 2alpha (HIF2α) in the process of renal cancer has been confirmed. In the field of tumour research, oxidative stress is also considered to be an important influencing factor. However, the relationship and biological benefits of oxidative stress and HIF2α in ccRCC remain unclear. This research attempts to explore the effect of oxidative stress on the cancer-promoting effect of HIF2α in ccRCC and reveal its mechanism of action. METHODS The bioinformatics analysis for ccRCC is based on whole transcriptome sequencing and TCGA database. The detection of the expression level of related molecules is realised by western blot and PCR. The expression of Nucleoside diphosphate-linked moiety X-type motif 1 (NUDT1) was knocked down by lentiviral infection technology. The functional role of NUDT1 were further investigated by CCK8 assays, transwell assays and cell oxidative stress indicator detection. The exploration of related molecular mechanisms is realised by Luciferase assays and Chromatin immunoprecipitation (ChIP) assays. RESULTS Molecular screening based on knockdown HIF2α sequencing data and oxidative stress related data sets showed that NUDT1 is considered to be an important molecule for the interaction of HIF2α with oxidative stress. Subsequent experimental results showed that NUDT1 can cooperate with HIF2α to promote the progression of ccRCC. And this biological effect was found to be caused by the oxidative stress regulated by NUDT1. Mechanistically, HIF2α transcription activates the expression of NUDT1, thereby inhibiting oxidative stress and promoting the progression of ccRCC. CONCLUSIONS This research clarified a novel mechanism by which HIF2α stabilises sirtuin 3 (SIRT3) through direct transcriptional activation of NUDT1, thereby inhibiting oxidative stress to promote the development of ccRCC. It provided the possibility for the selection of new therapeutic targets for ccRCC and the study of combination medication regimens.
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Affiliation(s)
- Jian Shi
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Zhiyong Xiong
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Keshan Wang
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Changfei Yuan
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Yu Huang
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Wen Xiao
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Xiangui Meng
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Zhixian Chen
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Qingyang Lv
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Daojia Miao
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Huageng Liang
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Tianbo Xu
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Kairu Xie
- Department of Pathogenic BiologySchool of Basic MedicineHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Hongmei Yang
- Department of Pathogenic BiologySchool of Basic MedicineHuazhong University of Science and TechnologyWuhanHubeiP. R. China
| | - Xiaoping Zhang
- Department of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
- Institute of UrologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP. R. China
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Xiao S, Xu G, Wang Z, Chong T. Chaperon‑mediated autophagy can promote proliferation and invasion of renal carcinoma cells and inhibit apoptosis through PKM2. Oncol Rep 2021; 46:214. [PMID: 34368882 DOI: 10.3892/or.2021.8165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/21/2021] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to explore the effect of chaperon‑mediated autophagy (CMA) through pyruvate kinase isoform M2 (PKM2) on the development of renal carcinoma (RCC) and its possible mechanisms. Lysosome‑associated membrane protein 2A (LAMP‑2A) and PKM2 expression levels were detected by collecting tissue samples from RCC patients. RNA interference was used to silence the LAMP‑2A and PKM2 expression levels in renal cell line A498 to detect the proliferation, apoptosis and invasion of cells. The levels of mRNA and protein of related genes were also examined. Co‑immunoprecipitation was used to detect the interaction between PKM2 and heat shock cognate 70 (HSC70). The results revealed that LAMP‑2A and PKM2 expression levels were significantly increased in RCC tissues and cell lines (P<0.01). LAMP‑2A silencing increased the expression level of PKM2 in A498 and 786‑O cells. LAMP‑2A and PKM2 silencing suppressed the proliferation and invasion and induced the apoptosis of A498 cells, and also affected the expression levels of related genes. Co‑immunoprecipitation revealed the interaction between PKM2 and HSC70. In conclusion, CMA could affect the proliferation, invasion and apoptosis of RCC cells through PKM2, and our findings provided new biomarkers and targets for molecular targeted therapy of RCC.
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Affiliation(s)
- Shangwen Xiao
- Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Gang Xu
- Department of Urology, Ankang Hospital of Traditional Chinese Medicine, Ankang, Shaanxi 72500, P.R. China
| | - Zhenlong Wang
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Tie Chong
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
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Samoylenko A, Kögler M, Zhyvolozhnyi A, Makieieva O, Bart G, Andoh SS, Roussey M, Vainio SJ, Hiltunen J. Time-gated Raman spectroscopy and proteomics analyses of hypoxic and normoxic renal carcinoma extracellular vesicles. Sci Rep 2021; 11:19594. [PMID: 34599227 PMCID: PMC8486794 DOI: 10.1038/s41598-021-99004-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 09/14/2021] [Indexed: 01/08/2023] Open
Abstract
Extracellular vesicles (EVs) represent a diverse group of small membrane-encapsulated particles involved in cell-cell communication, but the technologies to characterize EVs are still limited. Hypoxia is a typical condition in solid tumors, and cancer-derived EVs support tumor growth and invasion of tissues by tumor cells. We found that exposure of renal adenocarcinoma cells to hypoxia induced EV secretion and led to notable changes in the EV protein cargo in comparison to normoxia. Proteomics analysis showed overrepresentation of proteins involved in adhesion, such as integrins, in hypoxic EV samples. We further assessed the efficacy of time-gated Raman spectroscopy (TG-RS) and surface-enhanced time-gated Raman spectroscopy (TG-SERS) to characterize EVs. While the conventional continuous wave excitation Raman spectroscopy did not provide a notable signal, prominent signals were obtained with the TG-RS that were further enhanced in the TG-SERS. The Raman signal showed characteristic changes in the amide regions due to alteration in the chemical bonds of the EV proteins. The results illustrate that the TG-RS and the TG-SERS are promising label free technologies to study cellular impact of external stimuli, such as oxygen deficiency, on EV production, as well as differences arising from distinct EV purification protocols.
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Affiliation(s)
- Anatoliy Samoylenko
- Laboratory of Developmental Biology, Disease Networks Research Unit, Faculty of Biochemistry and Molecular Medicine, University of Oulu and Kvantum Institute, 90014, Oulu, Finland.
| | - Martin Kögler
- VTT Technical Research Centre of Finland, 90570, Oulu, Finland
| | - Artem Zhyvolozhnyi
- Laboratory of Developmental Biology, Disease Networks Research Unit, Faculty of Biochemistry and Molecular Medicine, University of Oulu and Kvantum Institute, 90014, Oulu, Finland
| | - Olha Makieieva
- Laboratory of Developmental Biology, Disease Networks Research Unit, Faculty of Biochemistry and Molecular Medicine, University of Oulu and Kvantum Institute, 90014, Oulu, Finland
| | - Geneviève Bart
- Laboratory of Developmental Biology, Disease Networks Research Unit, Faculty of Biochemistry and Molecular Medicine, University of Oulu and Kvantum Institute, 90014, Oulu, Finland
| | - Sampson S Andoh
- Institute of Photonics, University of Eastern Finland, 80101, Joensuu, Finland
| | - Matthieu Roussey
- Institute of Photonics, University of Eastern Finland, 80101, Joensuu, Finland
| | - Seppo J Vainio
- Laboratory of Developmental Biology, Disease Networks Research Unit, Faculty of Biochemistry and Molecular Medicine, University of Oulu and Kvantum Institute, 90014, Oulu, Finland
| | - Jussi Hiltunen
- VTT Technical Research Centre of Finland, 90570, Oulu, Finland
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Stewart GA, Smith CJ, Muchtar E. 67-Year-Old Man With Fatigue, Lightheadedness, and Erythrocytosis. Mayo Clin Proc 2021; 96:1949-1954. [PMID: 34218867 DOI: 10.1016/j.mayocp.2020.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Glenn A Stewart
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Caleb J Smith
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Eli Muchtar
- Advisor to residents and Consultant in Hematology, Mayo Clinic, Rochester, MN.
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Chung JS, Hong SK, Lee SC, Jeong CW, Kwak C, Kim HH, Hong SH, Kim YJ, Kang SH, Chung J, Kwon TG, Hwang EC, Byun SS. Impact of short warm ischemic time on longitudinal kidney function and survival rate after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease stage III: A multi-institutional propensity score-matched study. Eur J Surg Oncol 2020; 47:470-476. [PMID: 32631709 DOI: 10.1016/j.ejso.2020.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/03/2020] [Accepted: 06/11/2020] [Indexed: 01/30/2023] Open
Abstract
PURPOSE It remains unclear whether a short warm ischemic time (WIT) improves long-term renal function after partial nephrectomy (PN) for patients with pre-existing chronic kidney disease (CKD). We evaluated renal function after PN according to WIT duration in patients with stage III CKD. MATERIALS AND METHODS We identified 277 patients with stage III CKD who underwent PN during 2004-2017. Propensity score matching was used to created two matched groups of patients: Group A (WIT of <25 min) and Group B (WIT of ≥25 min). The outcomes of interest were longitudinal kidney function change, new-onset stage IV CKD (eGFR <30 mL/min/1.73 m2) and overall survival. RESULTS The two matched groups contained 85 patients each. The median follow-up durations were 49 months in Group A and 42 months in Group B. The median pre-treatment eGFRs were 52.4 mL/min/1.73 m2 in Group A and 52.6 mL/min/1.73 m2 in Group B. There were no differences in kidney function between the two groups throughout the follow-up period (P > 0.05). The 5-year rates of new-onset stage IV CKD were not significantly different between Group A and Group B (8.2% vs. 7.1%), with no significant difference in the risk of developing stage IV CKD in Group A (vs. group B, hazard ratio: 0.527, 95% confidence interval: 0.183-1.521; P = 0.236). The 5-year overall survival rates were 90.3% for Group A and 96.2% for Group B (P = 0.549). CONCLUSIONS A short WIT was not associated with better postoperative kidney function or survival after PN in patients with stage III CKD.
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Affiliation(s)
- Jae-Seung Chung
- Department of Urology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sang Chul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Yong June Kim
- Department of Urology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jinsoo Chung
- Department of Urology, National Cancer Center, Goyang, Republic of Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University Medical Center, Daegu, Republic of Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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8
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John J, Henry M, Ringoir A, Pinto G, Kesner K, Lazarus J, Sinha S. Change in renal function post-nephrectomy for renal cell carcinoma in patients with and without hypertension and/or diabetes. S AFR J SURG 2020; 58:101-104. [PMID: 32644314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND The standard of care for surgically resectable disease renal cell carcinoma (RCC) is a nephrectomy. Post-nephrectomy, these patients are at risk for the development of new onset chronic kidney disease or the progression of pre-existing chronic kidney disease. We aimed to report the changes in renal function in patients who had a nephrectomy for RCC. METHODS This retrospective, descriptive, cross-sectional study identified 137 patients who had a nephrectomy for RCC from 1 January 2009 to 31 December 2017. The pre-nephrectomy and post-nephrectomy estimated glomerular filtration rate (eGFR) and the histological subtype of RCC on histopathological analysis of the resected specimen were recorded from the National Health Laboratory Services online results platform. All analyses were conducted using SPSS (Version 25) and the significance level was set at p < 0.05. RESULTS After a mean follow-up period of 26.5 ± 22 months (median = 19 months), the patients' eGFR dropped by a mean of 4.82 ± 8.67 ml/min/1.73 m2 (95% CI 3.23-6.41) post-nephrectomy. The mean eGFR fall in patients' who had hypertension and/or diabetes (n = 63) was significantly larger compared to patients who had neither of these comorbidities (n = 54; p < .001; mean = 7.30 ± 8.40 ml/min/1.73 m2 (95% CI 5.19-9.42) and 1.93 ± 8.14 ml/min/1.73 m2 (95% CI 0.30-4.15) respectively. CONCLUSIONS The decline in renal function in patients with hypertension and/or diabetes mellitus is more pronounced than in patients with neither of these comorbidities. In these high-risk patients, measures must be taken to prevent the development and limit the progression of chronic kidney disease.
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Affiliation(s)
- J John
- Department of Urology, Walter Sisulu University and Frere Hospital, South Africa and Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa
| | - M Henry
- Centre for Higher Education Development, University of Cape Town, South Africa
| | - A Ringoir
- Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa
| | - G Pinto
- Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa
| | - K Kesner
- Department of Urology, Walter Sisulu University and Frere Hospital, South Africa
| | - J Lazarus
- Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa
| | - S Sinha
- Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa
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9
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Haeberle MT, Jung J, Brown TS. Recent-onset bloody nodule. J Fam Pract 2020; 69:209-211. [PMID: 32437488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
An antibiotic ointment failed to clear the lesion on the patient's back. A more detailed history revealed the nodule's troubling genesis.
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Affiliation(s)
- M Tye Haeberle
- Division of Dermatology, University of Louisville, Kentucky, USA.
| | - Jae Jung
- Division of Dermatology, University of Louisville, Kentucky, USA
| | - Timothy S Brown
- Division of Dermatology, University of Louisville, Kentucky, USA
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10
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Lin X, Goyal R, Yang XJ. Pathologic characterization of renal epithelial neoplasms arising in nonfunctioning kidneys. Hum Pathol 2019; 97:1-7. [PMID: 31857138 DOI: 10.1016/j.humpath.2019.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/18/2022]
Abstract
Nonfunctioning kidneys secondary to various etiologies display different histopathological features. Studies focused on incidence and types of renal neoplasms using the new World Health Organization and International Society of Urological Pathology classification system in various types of nonfunctioning kidneys are very limited. We identified 311 nephrectomies of nonfunctioning kidneys and categorized them into 5 categories: acquired cystic kidney disease (ACKD, n = 61); end-stage renal disease, nonspecific (ESRD, n = 63); adult polycystic kidney disease (APKD, n = 49); failed transplant kidney (FTK, n = 96); and those caused by obstructive conditions in the kidney (OCK, n = 42). ACKD (70%) and ESRD (43%) had higher cancer incidences than the other 3 groups (APKD = 2%, FTK = 0%, and OCK = 5%). Besides clear cell renal cell carcinoma (RCC) and papillary RCC, clear cell papillary RCC had a much higher incidence within ACKD patients (13/61) compared to other groups. ACKD-associated RCC was only identified in ACKD patients. ACKD patients had significantly longer dialysis duration compared to ESRD, APKD, and FTK. Although they had similar risk for clear cell RCC and papillary RCC, ACKD patients had a much higher risk for ACKD-associated RCC and clear cell papillary RCC than ESRD patients. Although most RCCs arising in these nonfunctioning kidneys were early pT1 stage, 6 ACKD patients and 3 ESRD patients had higher-stage diseases, which can be fatal if not treated appropriately. Therefore, precise clinicopathological classification of these nonfunctioning kidneys is important for predicting kidney cancer risk. These results indicate the need for active monitoring of the patients with high-risk nonfunctioning kidney diseases and appropriate surgical treatment when necessary.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Renal Cell/epidemiology
- Carcinoma, Renal Cell/pathology
- Carcinoma, Renal Cell/physiopathology
- Carcinoma, Renal Cell/surgery
- Female
- Humans
- Incidence
- Kidney Diseases, Cystic/epidemiology
- Kidney Diseases, Cystic/pathology
- Kidney Diseases, Cystic/physiopathology
- Kidney Diseases, Cystic/therapy
- Kidney Failure, Chronic/epidemiology
- Kidney Failure, Chronic/pathology
- Kidney Failure, Chronic/physiopathology
- Kidney Failure, Chronic/therapy
- Kidney Neoplasms/epidemiology
- Kidney Neoplasms/pathology
- Kidney Neoplasms/physiopathology
- Kidney Neoplasms/surgery
- Kidney Transplantation
- Male
- Middle Aged
- Nephrectomy
- Polycystic Kidney Diseases/epidemiology
- Polycystic Kidney Diseases/pathology
- Polycystic Kidney Diseases/physiopathology
- Polycystic Kidney Diseases/therapy
- Prognosis
- Renal Dialysis
- Risk Assessment
- Risk Factors
- Treatment Failure
- Young Adult
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Affiliation(s)
- Xiaoqi Lin
- Department of Pathology, Northwestern University, Chicago, IL 60611
| | - Rajen Goyal
- Department of Pathology, Northwestern University, Chicago, IL 60611
| | - Ximing J Yang
- Department of Pathology, Northwestern University, Chicago, IL 60611.
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11
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Dong JS, Wu B, Zha ZL. MicroRNA-588 regulates migration capacity and invasiveness of renal cancer cells by targeting EIF5A2. Eur Rev Med Pharmacol Sci 2019; 23:10248-10256. [PMID: 31841179 DOI: 10.26355/eurrev_201912_19662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate whether microRNA-588 was involved in the development and progression of renal cancer, and to explore its possible regulatory mechanisms. PATIENTS AND METHODS Tumor tissues excised from renal carcinoma and adjacent normal tissues were selected for the experiment. Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to analyze the expression level of microRNA-588 in tissue specimens. The relationship between the expression of microRNA-588 and the prognosis of patients with renal cell carcinoma was also evaluated. Subsequently, two renal cancer cell lines, including769-P and 786-O, were selected for functional experiments in vitro. Eukaryotic initiation factor 5A2 (pcDNA-EIF5A2) or microRNA-588 mimics was transfected into 769-P cells, respectively. Meanwhile, si-EIF5A2 or microRNA-588 inhibitor was transfected into 786-O cells. After that, the mRNA expression level of EIF5A2 was detected by qRT-PCR. The invasiveness and metastasis abilities of the two cell lines were evaluated via transwell assay. Furthermore, the levels of EIF5A2 and epithelial-mesenchymal transition (EMT)-related proteins were analyzed using Western blot. Luciferase reporter gene assay was used to confirm that microRNA-588 could directly regulate EIF5A2 expression. QRT-PCR and Western blot were performed to explore the mRNA and protein expressions of EIF5A2 in patients with highly or lowly-expressed microRNA-588. The correlation between the two molecules was evaluated using linear analysis. Through the above experiments, it was verified whether microRNA-588 could enhance the invasiveness and metastasis of renal cancer by targeting EIF5A2. RESULTS MicroRNA-588 expression in tumor tissues of patients with renal carcinoma was significantly decreased with the increase of tumor diameter and stage. A higher level of microRNA-588 indicated significantly longer overall survival of patients. This suggested that microRNA-588 expression was negatively correlated with the prognosis of patients. Overexpression of microRNA-588 remarkably reduced the invasion and metastasis abilities of 769-P cells, as well as the expressions of EMT-related proteins. However, opposite results were observed in 786-O cells after knockdown of microRNA-588. Reporter gene assay confirmed that microRNA-588 could target bind to EIF5A2. In 769-P cells, up-regulated microRNA-588 significantly inhibited the mRNA and protein expressions of EIF5A2. However, down-regulated microRNA-588 in 786-O cells significantly enhanced the expressions of EIF5A2 at both mRNA and protein levels. Linear analysis verified that microRNA-588 was negatively correlated with EIF5A2 at the mRNA level. Additionally, the up-regulation of EIF5A2 in 769-P cells enhanced the malignancy of cancer cells and the expressions of EMT-related proteins. However, in 786-O cells, opposite results were observed after knockdown of EIF5A2. CONCLUSIONS MicroRNA-588 was lowly expressed in renal cancer tissues and cell lines. This might lead to an increase in the protein level of EIF5A2, eventually promoting tumor invasion and metastasis.
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Affiliation(s)
- J-S Dong
- Department of Urology Surgery, Lianshui County People's Hospital, Huaian, China.
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12
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Zeng J, Xiang W, Zhang Y, Huang C, Chen K, Chen Z. Ubiquitous expressed transcript promotes tumorigenesis by acting as a positive modulator of the polycomb repressive complex 2 in clear cell renal cell carcinoma. BMC Cancer 2019; 19:874. [PMID: 31481081 PMCID: PMC6724258 DOI: 10.1186/s12885-019-6069-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 08/20/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The ubiquitous expressed transcript (UXT) plays a key role in various tumors by regulating transcriptional activity of multiple transcription factors, including androgen receptor (AR). However, the role of UXT in clear cell renal cell carcinoma (ccRCC) is still unknown. METHODS Yeast two-hybrid screening, GST pull-down and co-immunoprecipitation assays were performed to detect the interacting protein of UXT. Chromatin immunoprecipitation (ChIP) was performed to investigate the levels of histone H3 lysine 27 trimethylation at the HOXA9 promoters. CCK-8 assays, colony formation assays and Transwell assays were performed to detect the proliferation, colony formation, migration and invasion of renal cancer cells. Quantitative PCR analysis was performed to detect the expressions of UXT in human ccRCC samples. RESULTS The enhancer of zeste homolog 2 (EZH2) is a novel UXT interacting protein and UXT interacts with EZH2 in the nucleus. In addition, UXT interacts with the polycomb repressive complex 2 (PRC2) through directly binding to EZH2 and suppressor of zeste 12 homolog (SUZ12), but not to embryonic ectoderm development (EED). Moreover, the UXT activates EZH2 histone methyltransferase activity by facilitating EZH2 binding with SUZ12. We further provided striking evidences that knockdown of UXT inhibits proliferation, colony formation, migration and invasion of renal cancer cells, in an EZH2-dependent manner. Importantly, the upregulation of UXT expression was observed in clinical ccRCC samples, and the high expression level of UXT was associated with advanced stage, distant metastasis and poor overall survival in patients with ccRCC. CONCLUSION The UXT is a novel regulator of the PRC2 and acts as a renal cancer oncogene that affects the progression and survival of ccRCC patients.
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Affiliation(s)
- Jin Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 People’s Republic of China
- Department of Urology, the First Affiliated Hospital of Nanchang University, Nanchang, 330000 People’s Republic of China
| | - Wei Xiang
- College of Basic Medicine, Hubei University of Traditional Chinese Medicine, Wuhan, 430065 People’s Republic of China
| | - Yucong Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 People’s Republic of China
- Department of Geriatric, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 People’s Republic of China
| | - Chunhua Huang
- College of Basic Medicine, Hubei University of Traditional Chinese Medicine, Wuhan, 430065 People’s Republic of China
| | - Ke Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 People’s Republic of China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 People’s Republic of China
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13
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Kisa E, Yucel C, Keskin MZ, Karabicak M, Yalcin MY, Cakmak O, Ilbey YO. The Role of Hematological Parameters in Predicting Fuhrman Grade and Tumor Stage in Renal Cell Carcinoma Patients Undergoing Nephrectomy. ACTA ACUST UNITED AC 2019; 55:medicina55060287. [PMID: 31216752 PMCID: PMC6630220 DOI: 10.3390/medicina55060287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/09/2019] [Accepted: 06/17/2019] [Indexed: 01/04/2023]
Abstract
Background and objective: We investigated the ability of preoperative serum values of red blood cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and plateletcrit (PCT) to predict Fuhrman grades (FG) and tumor stages of renal cell carcinoma in patients who underwent radical nephrectomy. Materials and methods: Records of 283 patients that underwent radical or partial nephrectomy of renal masses at our clinic between January 2010 and April 2018, whose pathology results indicated renal cell carcinoma (RCC), and who had their FG and T1–4 N0M0 identified were retrospectively evaluated. The patients were divided into two groups based on their FG as low (I–II) and high (III–IV) and their T stages were similarly grouped as limited to kidney (pT1–pT2) and not limited to kidney (pT3–pT4). Results: Mean RDW, NLR, PCT cut-off values of the patients for FG and T stage were 15.65%, 3.54, 0.28% and 14.35%, 2.69, 0.28%, respectively. The RDW and NLR were determined to be statistically significant predictors of a pathologically high FG, whereas the PCT value was not a statistically significant predictor of high FG (p = 0.003, p = 0.006, p = 0.075, respectively). The relationship of RDW, NLR and PCT values with a limited to the kidney pathological T stage revealed statistically significant correlations for all three values. Conclusions: We determined that only RDW and NLR were markers predicting FG, while PCT had no prognostic value. On the other hand, all three of these values were associated with a limited to the kidney pathological T stage in patients who underwent nephrectomy due to renal masses and whose pathologies suggested RCC.
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Affiliation(s)
- Erdem Kisa
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Cem Yucel
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Mehmet Zeynel Keskin
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Mustafa Karabicak
- Department of Urology, Batman Training and Research Hospital, 72070 Batman, Turkey.
| | - Mehmet Yigit Yalcin
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Ozgur Cakmak
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
| | - Yusuf Ozlem Ilbey
- Department of Urology, Tepecik Training and Research Hospital, 35180 Izmir, Turkey.
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14
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Abstract
To assess whether left and right-sided renal cell carcinoma (RCC) carry side-specific outcomes.Surgically treated RCC patients were included from the United States Surveillance, Epidemiology and End Results database (Surveillance, Epidemiology and End Results database [SEER]; 2013 version) and the German Centre for Cancer Registry Data (ZfKD; 2000-2014). Bilateral RCC, those with missing RCC staging, follow-up time, and survival status were excluded. Cancer-specific survival (CSS) according to RCC side was compared using multivariable Cox regression.Seventeen thousand seven hundred nine SEER patients and 41,967 ZfKD patients were included. In both datasets, patients with left-sided RCC had higher T status and more often presented with nodal positive or metastatic disease. In the SEER dataset 1258 (14.33%) patients with left-sided RCC underwent lymphadenectomy (LAD), compared to 908 (10.17%) LADs in right-sided RCC (P <.001). CSS was inferior for left-sided in both datasets after multivariable adjustment (SEER HR = 1.187, 95% CI 1.048-1.345, P = .007, P = .008; ZfKD HR = 1.155, 95% CI 1.046-1.275, P = .004).In the SEER population, site-specific CSS differences were driven by whether or not a LAD was performed. Among SEER patients with LAD no statistically significant differences in laterality were observed (HR 1.096, 95% CI 0.8977-1.337, P = .396) whereas, in absence of LAD, CSS was shorter for individuals with left-sided tumor (HR = 1.176, 95%CI 1.002-1.38, P = .0468).Although the overall survival difference was only marginal, left-sided RCC in surgically treated patients tends to present at more advanced stage and has in general worse CSS, especially in patients without LAD. Site-specific lymphogenic spread patterns might contribute to these findings. Further prospective studies should evaluate, whether side-adapted LAD protocols influence outcomes in RCC patients.
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Affiliation(s)
| | - Johannes Uhlig
- Department of Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
- Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Joachim Lotz
- Department of Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
- German Centre for Cardiovascular Research, Partnersite Goettingen, Goettingen, Germany
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15
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Zhai X, Yuan S, Yang X, Zou P, Li L, Li G, Shao Y, Abd El-Aty AM, Hacımüftüoğlu A, Wang J. Chitosan Oligosaccharides Induce Apoptosis in Human Renal Carcinoma via Reactive-Oxygen-Species-Dependent Endoplasmic Reticulum Stress. J Agric Food Chem 2019; 67:1691-1701. [PMID: 30658530 DOI: 10.1021/acs.jafc.8b06941] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In recent years, various studies have confirmed the role of natural products as effective cancer prevention and treatment drugs. The present study demonstrated that chitosan oligosaccharide (COS) from shells of shrimp and crab caused an inhibitory effect on the proliferation of human renal carcinoma in vitro and in vivo. First, the in vivo biodistribution of COS was investigated by the synthesis of cyanine-7-labeled COS (COS-Cy7) following tail vein injection. The kidney was found to be a major target organ. Then, the impacts on renal carcinoma cell proliferation, apoptosis, and reactive oxygen species (ROS) production were observed in vitro, and an orthotopic xenograft tumor model was designed to evaluate the antitumor efficacy of COS in vivo. In renal carcinoma cells, COS induced G2/M phase arrest and apoptosis in a ROS-dependent fashion. COS significantly promoted mRNA expression of nuclear factor erythroid 2-related factor (Nrf2) and Nrf2 target genes, such as heme oxygenase 1, modifier subunit of glutamate cysteine ligase, and solute carrier family 7 member 11. Additionally, COS significantly upregulated the protein expression of glucose-regulated protein 78, protein RNA-like endoplasmic reticulum (ER) kinase, eukaryotic initiation factor 2α, activating transcription factor 4, C/EBP homologous protein, and cytochrome c, which justified the activation of the ER stress signaling pathway. In vivo, COS repressed tumor growth and induced apoptosis and ROS accumulation, consistent with the in vitro results. Taken together, COS repressed human renal carcinoma growth and induced apoptosis both in vitro and in vivo, mainly via ROS-dependent ER stress pathways.
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Affiliation(s)
- Xingchen Zhai
- Department of Food Sciences and Engineering, School of Chemistry and Chemical Engineering , Harbin Institute of Technology , 92 West Dazhi Street , Nangang District, Harbin , Heilongjiang 150001 , People's Republic of China
- Key Laboratory of Agro-Product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Product , Chinese Academy of Agricultural Sciences , 12 Zhongguancun South Street , Haidian District, Beijing 100081 , People's Republic of China
- Department of Pharmacology and Toxicology , Beijing Institute of Radiation Medicine , Beijing 100850 , People's Republic of China
| | - Shoujun Yuan
- Department of Pharmacology and Toxicology , Beijing Institute of Radiation Medicine , Beijing 100850 , People's Republic of China
| | - Xin Yang
- Department of Food Sciences and Engineering, School of Chemistry and Chemical Engineering , Harbin Institute of Technology , 92 West Dazhi Street , Nangang District, Harbin , Heilongjiang 150001 , People's Republic of China
| | - Pan Zou
- Department of Food Sciences and Engineering, School of Chemistry and Chemical Engineering , Harbin Institute of Technology , 92 West Dazhi Street , Nangang District, Harbin , Heilongjiang 150001 , People's Republic of China
- Key Laboratory of Agro-Product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Product , Chinese Academy of Agricultural Sciences , 12 Zhongguancun South Street , Haidian District, Beijing 100081 , People's Republic of China
| | - Linna Li
- Department of Pharmacology and Toxicology , Beijing Institute of Radiation Medicine , Beijing 100850 , People's Republic of China
| | - Guoyou Li
- Department of Pharmacology and Toxicology , Beijing Institute of Radiation Medicine , Beijing 100850 , People's Republic of China
| | - Yong Shao
- Key Laboratory of Agro-Product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Product , Chinese Academy of Agricultural Sciences , 12 Zhongguancun South Street , Haidian District, Beijing 100081 , People's Republic of China
| | - A M Abd El-Aty
- Department of Pharmacology, Faculty of Veterinary Medicine , Cairo University , 12211 Giza , Egypt
- Department of Medical Pharmacology, Medical Faculty , Ataturk University , 25240 Erzurum , Turkey
| | - Ahmet Hacımüftüoğlu
- Department of Medical Pharmacology, Medical Faculty , Ataturk University , 25240 Erzurum , Turkey
| | - Jing Wang
- Department of Food Sciences and Engineering, School of Chemistry and Chemical Engineering , Harbin Institute of Technology , 92 West Dazhi Street , Nangang District, Harbin , Heilongjiang 150001 , People's Republic of China
- Key Laboratory of Agro-Product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Product , Chinese Academy of Agricultural Sciences , 12 Zhongguancun South Street , Haidian District, Beijing 100081 , People's Republic of China
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16
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Little RA, Jamin Y, Boult JKR, Naish JH, Watson Y, Cheung S, Holliday KF, Lu H, McHugh DJ, Irlam J, West CML, Betts GN, Ashton G, Reynolds AR, Maddineni S, Clarke NW, Parker GJM, Waterton JC, Robinson SP, O’Connor JPB. Mapping Hypoxia in Renal Carcinoma with Oxygen-enhanced MRI: Comparison with Intrinsic Susceptibility MRI and Pathology. Radiology 2018; 288:739-747. [PMID: 29869970 PMCID: PMC6122194 DOI: 10.1148/radiol.2018171531] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/21/2017] [Indexed: 12/28/2022]
Abstract
Purpose To cross-validate T1-weighted oxygen-enhanced (OE) MRI measurements of tumor hypoxia with intrinsic susceptibility MRI measurements and to demonstrate the feasibility of translation of the technique for patients. Materials and Methods Preclinical studies in nine 786-0-R renal cell carcinoma (RCC) xenografts and prospective clinical studies in eight patients with RCC were performed. Longitudinal relaxation rate changes (∆R1) after 100% oxygen inhalation were quantified, reflecting the paramagnetic effect on tissue protons because of the presence of molecular oxygen. Native transverse relaxation rate (R2*) and oxygen-induced R2* change (∆R2*) were measured, reflecting presence of deoxygenated hemoglobin molecules. Median and voxel-wise values of ∆R1 were compared with values of R2* and ∆R2*. Tumor regions with dynamic contrast agent-enhanced MRI perfusion, refractory to signal change at OE MRI (referred to as perfused Oxy-R), were distinguished from perfused oxygen-enhancing (perfused Oxy-E) and nonperfused regions. R2* and ∆R2* values in each tumor subregion were compared by using one-way analysis of variance. Results Tumor-wise and voxel-wise ∆R1 and ∆R2* comparisons did not show correlative relationships. In xenografts, parcellation analysis revealed that perfused Oxy-R regions had faster native R2* (102.4 sec-1 vs 81.7 sec-1) and greater negative ∆R2* (-22.9 sec-1 vs -5.4 sec-1), compared with perfused Oxy-E and nonperfused subregions (all P < .001), respectively. Similar findings were present in human tumors (P < .001). Further, perfused Oxy-R helped identify tumor hypoxia, measured at pathologic analysis, in both xenografts (P = .002) and human tumors (P = .003). Conclusion Intrinsic susceptibility biomarkers provide cross validation of the OE MRI biomarker perfused Oxy-R. Consistent relationship to pathologic analyses was found in xenografts and human tumors, demonstrating biomarker translation. Published under a CC BY 4.0 license. Online supplemental material is available for this article.
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Affiliation(s)
- Ross A. Little
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Yann Jamin
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Jessica K. R. Boult
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Josephine H. Naish
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Yvonne Watson
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Susan Cheung
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Katherine F. Holliday
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Huiqi Lu
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Damien J. McHugh
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Joely Irlam
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Catharine M. L. West
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Guy N. Betts
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Garry Ashton
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | | | - Satish Maddineni
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Noel W. Clarke
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Geoff J. M. Parker
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - John C. Waterton
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - Simon P. Robinson
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
| | - James P. B. O’Connor
- From the Centre for Imaging Sciences (R.A.L., J.H.N., Y.W., S.C.,
K.F.H., H.L., D.J.M., G.J.M.P., J.C.W.) and Division of Cancer Sciences (J.I.,
C.M.L.W., N.W.C., J.P.B.O.), University of Manchester, Manchester, England;
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London,
England (Y.J., J.K.R.B., S.P.R.); Department of Pathology, Central Manchester
University Hospitals NHS Foundation Trust, Manchester, England (G.N.B.);
Department of Histology, CRUK Manchester Institute, Manchester, England (G.A.);
Tumour Biology Team, The Breast Cancer Now Toby Robins Research Centre, The
Institute of Cancer Research, London, England (A.R.R.); Department of Urology,
Salford Royal Hospitals NHS Foundation Trust, Salford, England (S.M., N.W.C.);
Bioxydyn Ltd, Manchester, England (G.J.M.P., J.C.W.); and Department of
Radiology, The Christie NHS Foundation Trust, Manchester, England
(J.P.B.O.)
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17
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Marzouk K, Tin A, Liu N, Sjoberg D, Hakimi AA, Russo P, Coleman J. The natural history of large renal masses followed on observation. Urol Oncol 2018; 36:362.e17-362.e21. [PMID: 29853347 PMCID: PMC6701866 DOI: 10.1016/j.urolonc.2018.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 04/26/2018] [Accepted: 05/01/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE The safety and feasibility of active surveillance in comorbid patients with renal masses ≥4.0cm is uncertain. The aim of this study is to describe our institutional experience with the observation of large renal masses. MATERIALS AND METHODS One hundred patients were identified with renal masses ≥ 4.0cm that were followed on observation for at least 6 months without surgical intervention between 1994 and 2016. Linear regression was conducted to determine predictors for renal mass growth and competing risk methods were used to estimate the probability of progression in the setting of death from other causes. RESULTS Median age at diagnosis was 73 years and 73% of patients had a Charlson Comorbidity index ≥ 4. At presentation, the median mass size was 4.9cm. The median growth rate was 0.4cm/y and there were no significant predictors of growth. Surveillance was discontinued in 34 patients who underwent delayed intervention. Median follow up for metastasis-free survivors was 4 years. In total, 10 patients developed metastatic disease, 3 died from kidney cancer and 30 patients died from other causes. The 5-year probability of other cause mortality was 22% (95% CI: 14%-32%) compared to 6% (95% CI: 2%-13%) for metastatic progression of kidney cancer. CONCLUSION In highly comorbid patients, the observation of large renal masses has low likelihood for metastatic progression relative to the risk of nonkidney cancer related death. This data supports the use of surveillance as an acceptable strategy for highly selected patients with competing risks from other serious illnesses.
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Affiliation(s)
- Karim Marzouk
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
| | - Amy Tin
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nick Liu
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Daniel Sjoberg
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Abraham Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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18
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Mondul AM, Weinstein SJ, Parisi D, Um CY, McCullough ML, Albanes D. Vitamin D-Binding Protein and Risk of Renal Cell Carcinoma in the Cancer Prevention Study-II Cohort. Cancer Epidemiol Biomarkers Prev 2018; 27:1203-1207. [PMID: 30030213 DOI: 10.1158/1055-9965.epi-18-0263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/04/2018] [Accepted: 07/16/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Kidney cancer has several well-established risk factors, including smoking, obesity, and hypertension. These factors do not, however, completely account for its etiology. One previous study of vitamin D-binding protein (DBP) and risk of renal cell carcinoma found a striking inverse association that warranted replication.Methods: We conducted a nested case-control study in the American Cancer Society Cancer Prevention Study-II Nutrition Cohort to prospectively examine circulating DBP concentration and renal cell carcinoma risk. Cases (n = 87) were matched 1:1 to controls on gender, race, age (±5 years), and date of blood collection (±30 days). ORs and 95% confidence intervals (CIs) were estimated for quartiles of DBP using conditional logistic regression.Results: There was a statistically significant inverse trend across quartiles of DBP such that participants with higher DBP had a markedly decreased risk of renal cell carcinoma (vs. Q1: Q2 OR, 0.93; 95% CI, 0.41-2.11; Q3 OR, 0.42; 95% CI, 0.15-1.15; Q4 OR, 0.33; 95% CI, 0.10-1.06; P trend = 0.03).Conclusions: Our findings demonstrate a strong inverse association between circulating DBP and risk of renal cell carcinoma, supporting the findings from previous research.Impact: This is only the second study to examine DBP and risk of kidney cancer, and one of only a handful of studies to examine circulating DBP and risk of cancer at any site. Our findings support emerging evidence for an etiologic role of DBP in cancer and may provide insights into the etiology of kidney and other cancers. Cancer Epidemiol Biomarkers Prev; 27(10); 1203-7. ©2018 AACR.
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Affiliation(s)
- Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland
| | - Dominick Parisi
- Information Management Services, Inc., Silver Spring, Maryland
| | - Caroline Y Um
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | | | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland
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19
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Czernuszewicz TJ, Papadopoulou V, Rojas JD, Rajamahendiran RM, Perdomo J, Butler J, Harlacher M, O’Connell G, Zukić D, Aylward SR, Dayton PA, Gessner RC. A new preclinical ultrasound platform for widefield 3D imaging of rodents. Rev Sci Instrum 2018; 89:075107. [PMID: 30068108 PMCID: PMC6045495 DOI: 10.1063/1.5026430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Noninvasive in vivo imaging technologies enable researchers and clinicians to detect the presence of disease and longitudinally study its progression. By revealing anatomical, functional, or molecular changes, imaging tools can provide a near real-time assessment of important biological events. At the preclinical research level, imaging plays an important role by allowing disease mechanisms and potential therapies to be evaluated noninvasively. Because functional and molecular changes often precede gross anatomical changes, there has been a significant amount of research exploring the ability of different imaging modalities to track these aspects of various diseases. Herein, we present a novel robotic preclinical contrast-enhanced ultrasound system and demonstrate its use in evaluating tumors in a rodent model. By leveraging recent advances in ultrasound, this system favorably compares with other modalities, as it can perform anatomical, functional, and molecular imaging and is cost-effective, portable, and high throughput, without using ionizing radiation. Furthermore, this system circumvents many of the limitations of conventional preclinical ultrasound systems, including a limited field-of-view, low throughput, and large user variability.
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Affiliation(s)
| | - Virginie Papadopoulou
- Joint Department of Biomedical Engineering, The University of North Carolina and North Carolina State University, Chapel Hill, North Carolina 27599, USA
| | - Juan D. Rojas
- Joint Department of Biomedical Engineering, The University of North Carolina and North Carolina State University, Chapel Hill, North Carolina 27599, USA
| | | | - Jonathan Perdomo
- SonoVol, Inc., Research Triangle Park, North Carolina 27709, USA
| | - James Butler
- SonoVol, Inc., Research Triangle Park, North Carolina 27709, USA
| | - Max Harlacher
- SonoVol, Inc., Research Triangle Park, North Carolina 27709, USA
| | - Graeme O’Connell
- SonoVol, Inc., Research Triangle Park, North Carolina 27709, USA
| | - Dženan Zukić
- Kitware, Inc., Carrboro, North Carolina 27510, USA
| | | | - Paul A. Dayton
- Joint Department of Biomedical Engineering, The University of North Carolina and North Carolina State University, Chapel Hill, North Carolina 27599, USA
| | - Ryan C. Gessner
- SonoVol, Inc., Research Triangle Park, North Carolina 27709, USA
- Author to whom correspondence should be addressed: . Current address: First Flight Venture Center, 2 Davis Dr., Research Triangle Park, NC 27709-3169. Telephone: 844-766-6865 x707
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20
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Bertolo R, Fiori C, Piramide F, Amparore D, Porpiglia F. The preoperative stratification of patients based on renal scan data is unable to predict the functional outcome after partial nephrectomy. Int Braz J Urol 2018; 44:740-749. [PMID: 29697937 PMCID: PMC6092664 DOI: 10.1590/s1677-5538.ibju.2017.0636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/26/2018] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION eGFR-categories are used to predict functional outcome after partial nephrectomy (PN); no study categorized patients according to preoperative renal scan (RS) data. Aim of the study was to evaluate if stratification of patients according to RS is a reliable method to predict minor/major loss of renal function after PN. MATERIALS AND METHODS We considered patients who underwent PN and RS pre-/post-PN for T1 tumor in our Institution (2007-2017). Demographics, perioperative and specifically functional data were analysed. On the basis of the baseline Split Renal Function (SRF), patients were stratified into risk-categories: 1) baseline operated-kidney SRF range 45-55%; 2) baseline operated-kidney SRF < 45%. Risk categories were analysed with postoperative functional outcome: postoperative operated-kidney SRF decrease below 90% of baseline was considered significant loss of function. Contingency tables and univariate/multivariate regression were analysed looking for independent factors of postoperative functional impairment. RESULTS 224 patients were analysed, 125 (55.8%) maintained >90% of their baseline function. Worse probability of maintaining ≥90 baseline renal function was found in patients with Charlson's Comorbidity Index (CCI≥3) (p=0.004) and patients with PADUA score ≥8 (p=0.023). After stratification by baseline renal function, ischemia was the only independent factor: no effect on patients with poorer baseline renal function. Patients with baseline SRF 45-55% who did not experience ischemia had the highest probability to maintain ≥90% baseline SRF (p=0.028). Ischemia >25 minutes was detrimental (p=0.017). CONCLUSIONS Stratification of patients by SRF before PN is not a reliable predictor of renal functional outcome. Ischemia seems to scarcely influence patients with poorer renal function.
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Affiliation(s)
- Riccardo Bertolo
- Division of Urology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Cristian Fiori
- Division of Urology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Federico Piramide
- Division of Urology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Daniele Amparore
- Division of Urology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
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21
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Ha YS, Kim YY, Yu NH, Chun SY, Choi SH, Lee JN, Kim BS, Yoo ES, Kwon TG. Down-regulation of transient receptor potential melastatin member 7 prevents migration and invasion of renal cell carcinoma cells via inactivation of the Src and Akt pathway. Investig Clin Urol 2018; 59:263-274. [PMID: 29984342 PMCID: PMC6028469 DOI: 10.4111/icu.2018.59.4.263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/17/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose Transient receptor potential melastatin member 7 (TRPM7), an ion channel and serine/threonine protein kinase, has been linked with distinct human malignancies. However, the role of TRPM7 in renal cell carcinoma (RCC) has not been investigated. The aim of this study is to determine whether TRPM7 regulates the migration and invasion of RCC cells. Its relationship with signal transduction pathways was also studied. Materials and Methods The human RCC cell lines ACHN and SN12C were chosen for this study. The molecular mechanisms of TRPM7 action were studied using Western blot analysis and small interfering RNA (siRNA)-based knockdown. The effect of TRPM7 knockdown on RCC cells was measured by using Transwell invasion and wound healing migration assays. Results siRNA-induced silencing of TRPM7 notably decreased the migration and invasion of ACHN and SN12C RCC cells. The phosphorylation levels of Src in both cells were obviously reduced after TRPM7 silencing compared with that of the control ACHN and SN12C cells. Furthermore, the phosphorylation levels of Akt were greatly decreased in ACHN cells after siRNA-induced knockdown of TRPM7. Additionally, the treatment of cells with Src and Akt inhibitors clearly limited the migration and invasion of RCC cells. Conclusions Our data show that TRPM7 regulated ACHN and SN12C RCC cell invasion via the Src/Akt signaling pathway. Therefore, targeting the Src/Akt signaling pathway and/or the expression or function of TRPM7 could be a potential beneficial treatment for patients with RCC.
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Affiliation(s)
- Yun-Sok Ha
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Yeon-Yong Kim
- Department of Pharmacology, Kyungpook National University School of Medicine, Daegu, Korea
- Immunoregulatory Material Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeongeup, Korea
| | - Na Hee Yu
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - So Young Chun
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Seock Hwan Choi
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Jun Nyung Lee
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Eun Sang Yoo
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Tae Gyun Kwon
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
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22
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Wang Z, Zhang K, Zhang H, Sun D, Li Y, Tan Q, Fu Q. A rare case report of one stage surgical treatment for left renal cell carcinoma with level IV intravenous tumor thrombus combined with severe coronary artery stenosis. Medicine (Baltimore) 2018; 97:e0433. [PMID: 29742686 PMCID: PMC5959390 DOI: 10.1097/md.0000000000010433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Renal cell carcinoma (RCC) exhibits a natural tendency to extend from the kidney into inferior vena cava (IVC) and growing into the right atrium is a rare complication. We report a 65-year-old patient with an RCC with intravascular extension through renal vein into the IVC and right atrial combined with severe coronary artery disease. This case has not been described in the literature and there is no treatment guideline for it. PATIENT CONCERNS A 65-year-old patient was admitted to our clinic with complaints of edema of both lower extremities. DIAGNOSES On the basis of the magnetic resonance imaging scan and coronary angiography, we strongly suspected an RCC with intravascular extension through renal vein into the IVC and right atrial combined with severe coronary artery disease. INTERVENTIONS We performed open left radical nephrectomy, IVC, and right atrium thrombectomy under cardiopulmonary bypass and coronary artery bypass grafting on beating heart. OUTCOMES The postoperative course was uneventful. The patient has been discharged from hospital. LESSONS Coexistence of severe coronary artery disease and RCC infiltrating inferior vena cava and right atrium rendered this operation as very high-risk procedure. We hope that our operational manners can prove the possibility of simultaneous difficult cardiac and urologic operation. The basic point of our report concerns the fact that the oncologic treatment was not delayed despite severe heart disease.
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Affiliation(s)
| | | | | | | | - Yong Li
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Qi Tan
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
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23
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Safi M, Sun X, Wang L, Zhang X, Song J, Ameen M. Risk interrelationship among multiple primary tumors: A case report and review of literature. Medicine (Baltimore) 2018; 97:e0289. [PMID: 29642151 PMCID: PMC5908637 DOI: 10.1097/md.0000000000010289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Along with advanced management in oncology, great progress has been recently achieved in the studies of multiple primary tumors. Several reports have studied the coexistence between lymphoma and either renal cell carcinoma (RCC) or Warthin tumor. However, the level of coexistence between these cases remains unclear due to the absence of a distinct link between them. PATIENT CONCERNS We present a unique case of multiple primary tumors (lymphoma, RCC, and Warthin tumor) in an 80-year-old man and a review of the literature on the coexistence of RCC with lymphoma and lymphoma with Warthin tumor. DIAGNOSIS With a history of RCC, the patient had a freely movable lump under his left ear, and the pathological report indicated Hodgkin lymphoma and Warthin tumor. INTERVENTION RCC and Warthin tumor of the patient were surgically treated, followed by 2 cycles (14 days per cycle) of Epirubicin 40 mg day 1, Bleomycin 8 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1. The chemotherapy protocol was then changed to Epirubicin 40 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1 for 7 cycles. OUTCOMES After the last day of chemotherapy, the patient showed a complete response. LESSONS To the best of our knowledge, this paper is the first to report a case of multiple primary tumors with a complete response. For their early detection, favorable prognosis, and correlation identification, we suggest a transitive relation between these coexisting tumors. Therefore, similar studies should be conducted.
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Affiliation(s)
- Mohammed Safi
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Xiuhua Sun
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Lifen Wang
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Xinwei Zhang
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Jicheng Song
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Mohammed Ameen
- Sino-German Cancer Diagnosis and Treatment Center, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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24
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Gallyamov EA, Agapov MA, Kubyshkin VA, Biktimirov RG, Malakhov PS, Zryanin AM, Kamalov AA, Lutsevich OE. [Multiple primary neoplasia of kidney, prostate and colon]. Khirurgiia (Mosk) 2018:98-100. [PMID: 29697693 DOI: 10.17116/hirurgia2018498-100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- E A Gallyamov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - M A Agapov
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - V A Kubyshkin
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - R G Biktimirov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - P S Malakhov
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - A M Zryanin
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - A A Kamalov
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - O E Lutsevich
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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25
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Antonelli A, Mari A, Longo N, Novara G, Porpiglia F, Schiavina R, Ficarra V, Carini M, Minervini A. Role of Clinical and Surgical Factors for the Prediction of Immediate, Early and Late Functional Results, and its Relationship with Cardiovascular Outcome after Partial Nephrectomy: Results from the Prospective Multicenter RECORd 1 Project. J Urol 2017; 199:927-932. [PMID: 29154848 DOI: 10.1016/j.juro.2017.11.065] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE We sought to determine the predictors of short-term and long-term renal function impairment after partial nephrectomy. MATERIALS AND METHODS Clinical data on 769 consecutive patients who underwent partial nephrectomy were prospectively recorded at a total of 19 urological Italian centers from 2009 to 2012 in the RECORd 1 (Italian Registry of Conservative Renal Surgery) Project. We extracted clinical data on 708 of these patients who were alive, free of recurrent disease and with a minimum 2-year functional followup. RESULTS Of the patients 47.3% underwent open, 36.6% underwent laparoscopic and 16.1% underwent robot-assisted partial nephrectomy. The median baseline estimated glomerular filtration rate was 84.5 ml/minute/1.73 m2 (IQR 69.9-99.1). Immediate (day 3 postoperatively), early (month 1) and late (month 24) renal function impairment greater than 25% from baseline was identified in 25.3%, 21.6% and 14.8% of cases, respectively. Female gender and the baseline estimated glomerular filtration rate were independent predictors of immediate, early and late renal function impairment. Age at diagnosis was an independent predictor of immediate and late impairment. Uncontrolled diabetes was an independent predictor of late impairment only. Open and laparoscopic approaches, and pedicle clamping were independent predictors of immediate and early renal function impairment. Overall 58 of 529 patients (11%) experienced postoperative cardiovascular events. Body mass index and late renal function impairment were independent predictors of those events. CONCLUSIONS Surgically modifiable factors were significantly associated with worse immediate and early functional outcomes after partial nephrectomy while clinically unmodifiable factors affected renal function during the entire followup. Late renal function impairment is an independent predictor of postoperative cardiovascular events.
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Affiliation(s)
- Alessandro Antonelli
- Department of Urology, Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Nicola Longo
- Department of Urology, Federico II Hospital, University of Naples, Naples, Italy
| | - Giacomo Novara
- Department of Urology, University of Padua, Padua, Italy
| | - Francesco Porpiglia
- Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Riccardo Schiavina
- Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Marco Carini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy.
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26
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Patel HD, Pierorazio PM, Johnson MH, Sharma R, Iyoha E, Allaf ME, Bass EB, Sozio SM. Renal Functional Outcomes after Surgery, Ablation, and Active Surveillance of Localized Renal Tumors: A Systematic Review and Meta-Analysis. Clin J Am Soc Nephrol 2017; 12:1057-1069. [PMID: 28483780 PMCID: PMC5498358 DOI: 10.2215/cjn.11941116] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/06/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Management strategies for localized renal masses suspicious for renal cell carcinoma include radical nephrectomy, partial nephrectomy, thermal ablation, and active surveillance. Given favorable survival outcomes across strategies, renal preservation is often of paramount concern. To inform clinical decision making, we performed a systematic review and meta-analysis of studies comparing renal functional outcomes for radical nephrectomy, partial nephrectomy, thermal ablation, and active surveillance. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 1997 to May 1, 2015 to identify comparative studies reporting renal functional outcomes. Meta-analyses were performed for change in eGFR, incidence of CKD, and AKI. RESULTS We found 58 articles reporting on relevant renal functional outcomes. Meta-analyses showed that final eGFR fell 10.5 ml/min per 1.73 m2 lower for radical nephrectomy compared with partial nephrectomy and indicated higher risk of CKD stage 3 or worse (relative risk, 2.56; 95% confidence interval, 1.97 to 3.32) and ESRD for radical nephrectomy compared with partial nephrectomy. Overall risk of AKI was similar for radical nephrectomy and partial nephrectomy, but studies suggested higher risk for radical nephrectomy among T1a tumors (relative risk, 1.37; 95% confidence interval, 1.13 to 1.66). In general, similar findings of worse renal function for radical nephrectomy compared with thermal ablation and active surveillance were observed. No differences in renal functional outcomes were observed for partial nephrectomy versus thermal ablation. The overall rate of ESRD was low among all management strategies (0.4%-2.8%). CONCLUSIONS Renal functional implications varied across management strategies for localized renal masses, with worse postoperative renal function for patients undergoing radical nephrectomy compared with other strategies and similar outcomes for partial nephrectomy and thermal ablation. Further attention is needed to quantify the changes in renal function associated with active surveillance and nephron-sparing approaches for patients with preexisting CKD.
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Affiliation(s)
- Hiten D. Patel
- James Buchanan Brady Urological Institute, Department of Urology, and
| | | | | | | | | | - Mohamad E. Allaf
- James Buchanan Brady Urological Institute, Department of Urology, and
| | - Eric B. Bass
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Departments of
- Health Policy and Management and
- Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; and
| | - Stephen M. Sozio
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Departments of
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
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27
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Schindler E, Amantea MA, Karlsson MO, Friberg LE. A Pharmacometric Framework for Axitinib Exposure, Efficacy, and Safety in Metastatic Renal Cell Carcinoma Patients. CPT Pharmacometrics Syst Pharmacol 2017; 6:373-382. [PMID: 28378918 PMCID: PMC5488123 DOI: 10.1002/psp4.12193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/13/2017] [Accepted: 03/15/2017] [Indexed: 01/15/2023] Open
Abstract
The relationships between exposure, biomarkers (vascular endothelial growth factor (VEGF), soluble VEGF receptors (sVEGFR)-1, -2, -3, and soluble stem cell factor receptor (sKIT)), tumor sum of longest diameters (SLD), diastolic blood pressure (dBP), and overall survival (OS) were investigated in a modeling framework. The dataset included 64 metastatic renal cell carcinoma patients (mRCC) treated with oral axitinib. Biomarker timecourses were described by indirect response (IDR) models where axitinib inhibits sVEGFR-1, -2, and -3 production, and VEGF degradation. No effect was identified on sKIT. A tumor model using sVEGFR-3 dynamics as driver predicted SLD data well. An IDR model, with axitinib exposure stimulating the response, characterized dBP increase. In a time-to-event model the SLD timecourse predicted OS better than exposure, biomarker- or dBP-related metrics. This type of framework can be used to relate pharmacokinetics, efficacy, and safety to long-term clinical outcome in mRCC patients treated with VEGFR inhibitors. (ClinicalTrial.gov identifier NCT00569946.).
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Affiliation(s)
- E Schindler
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | | | - M O Karlsson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - L E Friberg
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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28
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Li P, Han Q, Tang M, Zhang K. [Knockdown of ATG5 enhances the sensitivity of human renal carcinoma cells to sunitinib]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2017; 33:367-371. [PMID: 28274318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective To investigate the expression levels of autophagy-related gene 5 (ATG5) and microtubule-associated protein 1 light chain 3 (LC3) and their effects on sunitinib resistance in human renal carcinoma cells. Methods After clinic-pathologic feature and survival analysis, 99 renal clear cell carcinoma tissues with different histological grades were used to detect the expression of ATG5 and LC3 by immunohistochemistry. Renal carcinoma cell line A-498 was infected with lentivirus-mediated ATG5 shRNA. Western blot analysis was performed to confirm the efficiency of ATG5 knockdown. Proliferation rate of A-498 cells in control group and ATG5 low expression group was determined by flow cytometry. Finally, the survival rate was detected by MTT assay after A-498 cells were treated with different concentrations of sunitinib. Results The expression levels of ATG5 and LC3 in renal clear cell carcinoma tissues were significantly higher than those in para-tumor tissues. The expression levels of ATG5 and LC3 were associated with classification, histological grade, TNM stage and survival rate, rather than gender, age, location, tumor size. Compared with the control group, the protein expressions of ATG5 and LC3 significantly decreased in A-498 cells with ATG5 low expression. The cell proliferation rate in ATG5 downregulation group was lower than that in the control group. Compared with control group, the survival rate in ATG5 low expression group were significantly reduced in a dose-dependent manner after sunitinib treatment. Conclusion Autophagy is active in renal clear cell carcinoma, and the drug sensitivity to sunitinib in renal cancer cells can be enhanced by the downregulation of ATG5.
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Affiliation(s)
- Peng Li
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Qi Han
- Institute of Materia Medica, Third Military Medical University, Chongqing 400038, China
| | - Ming Tang
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Keqin Zhang
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. *Corresponding author, E-mail:
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29
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Gibson PD, Ippolito JA, Benevenia J. Radial Shaft Reconstruction With an Intercalary Endoprosthesis Following Resection of Metastatic Tumor. Orthopedics 2017; 40:e242-e247. [PMID: 27610702 DOI: 10.3928/01477447-20160901-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/01/2016] [Indexed: 02/03/2023]
Abstract
Improvements in imaging and treatment of musculoskeletal tumors have increased the variety of options for reconstruction following joint-sparing diaphyseal resection. The purpose of this case series was to show that reconstruction of malignant tumors of the radial shaft with an intercalary prosthesis may be an option for patients with segmental bone loss. Three consecutive patients underwent wide resection of the radial diaphysis followed by reconstruction with a custom intercalary prosthesis. A custom intercalary prosthesis with lap joint design was used in all 3 cases. Mean follow-up was 18 months (range, 9-25 months). All patients were weight bearing as tolerated 1 week postoperatively. At the most recent follow-up, patients' mean elbow flexion and extension arc was 137° (range, 130°-140°). At the forearm, mean supination was 60° (range, 30°-90°) and mean pronation was 70° (range, 60°-90°). At the wrist, mean palmar flexion was 80° (range, 70°-90°) and mean dorsiflexion was 80° (range, 70°-90°). All patients reported minimal to no pain and no significant functional limitations. Mean Musculoskeletal Tumor Society score was 26/30 (87%). Reconstruction with an intercalary prosthesis is a viable option for patients with metastatic disease of the radial shaft. All patients had satisfactory results and early return to function; none required return to the operating room. Possible advantages of reconstruction with an intercalary prosthesis compared with reconstruction with a bone graft or polymethylmethacrylate osteosynthesis include early return to function and minimal weight-bearing restrictions postoperatively. [Orthopedics. 2017; 40(2):e242-e247.].
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30
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Chen Y, Rini BI, Motzer RJ, Dutcher JP, Rixe O, Wilding G, Stadler WM, Tarazi J, Garrett M, Pithavala YK. Effect of Renal Impairment on the Pharmacokinetics and Safety of Axitinib. Target Oncol 2017; 11:229-34. [PMID: 26400730 DOI: 10.1007/s11523-015-0389-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Axitinib, an inhibitor of vascular endothelial growth factor (VEGF) receptors, is approved as second-line treatment for advanced renal cell carcinoma (RCC). Agents targeting the VEGF pathway may induce renal toxicities, which may be influenced by pre-existing renal dysfunction. OBJECTIVE The objective was to characterize axitinib pharmacokinetics and safety in patients with renal impairment. PATIENTS AND METHODS Effect of renal function (baseline creatinine clearance [CrCL]) on axitinib clearance was evaluated in a population pharmacokinetic model in 207 patients with advanced solid tumors who received a standard axitinib starting dose, and in 383 healthy volunteers. Axitinib safety according to baseline CrCL was assessed in previously treated patients with RCC (n = 350) who received axitinib in the phase 3 AXIS study. RESULTS Median axitinib clearance was 14.0, 10.7, 12.3, 7.81, and 12.6 L/h, respectively, in individuals with normal renal function (≥90 ml/min; n = 381), mild renal impairment (60-89 ml/min; n = 139), moderate renal impairment (30-59 ml/min; n = 64), severe renal impairment (15-29 ml/min; n = 5), and end-stage renal disease (<15 ml/min; n = 1). The population pharmacokinetic model adequately predicted axitinib clearance in individuals with severe renal impairment or end-stage renal disease. Grade ≥3 adverse events (AEs) were reported in 63 % of patients with normal renal function or mild impairment, 77 % with moderate impairment, and 50 % with severe impairment; study discontinuations due to AEs were 10 %, 11 %, and 0 %, respectively. CONCLUSIONS Axitinib pharmacokinetics and safety were similar regardless of baseline renal function; no starting-dose adjustment is needed for patients with pre-existing mild to severe renal impairment.
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Affiliation(s)
| | - Brian I Rini
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | | | | | - Olivier Rixe
- University of New Mexico Cancer Center, Albuquerque, NM, USA
| | - George Wilding
- University of Wisconsin Carbone Comprehensive Cancer Center, Madison, WI, USA
| | | | | | | | - Yazdi K Pithavala
- Pfizer Oncology, San Diego, CA, USA.
- Clinical Pharmacology, Pfizer Inc, 10555 Science Center Drive, San Diego, CA, 92121, USA.
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31
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Trevisani F, Ghidini M, Larcher A, Lampis A, Lote H, Manunta P, Alibrandi MTS, Zagato L, Citterio L, Dell'Antonio G, Carenzi C, Capasso G, Rugge M, Rigotti P, Bertini R, Cascione L, Briganti A, Salonia A, Benigni F, Braconi C, Fassan M, Hahne JC, Montorsi F, Valeri N. MicroRNA 193b-3p as a predictive biomarker of chronic kidney disease in patients undergoing radical nephrectomy for renal cell carcinoma. Br J Cancer 2016; 115:1343-1350. [PMID: 27802451 PMCID: PMC5129818 DOI: 10.1038/bjc.2016.329] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND A significant proportion of patients undergoing radical nephrectomy (RN) for clear-cell renal cell carcinoma (RCC) develop chronic kidney disease (CKD) within a few years following surgery. Chronic kidney disease has important health, social and economic impact and no predictive biomarkers are currently available. MicroRNAs (miRs) are small non-coding RNAs implicated in several pathological processes. METHODS Primary objective of our study was to define miRs whose deregulation is predictive of CKD in patients treated with RN. Ribonucleic acid from formalin-fixed paraffin embedded renal parenchyma (cortex and medulla isolated separately) situated >3 cm from the matching RCC was tested for miR expression using nCounter NanoString technology in 71 consecutive patients treated with RN for RCC. Validation was performed by RT-PCR and in situ hybridisation. End point was post-RN CKD measured 12 months post-operatively. Multivariable logistic regression and decision curve analysis were used to test the statistical and clinical impact of predictors of CKD. RESULTS The overexpression of miR-193b-3p was associated with high risk of developing CKD in patients undergoing RN for RCC and emerged as an independent predictor of CKD. The addition of miR-193b-3p to a predictive model based on clinical variables (including sex and estimated glomerular filtration rate) increased the sensitivity of the predictive model from 81 to 88%. In situ hybridisation showed that miR-193b-3p overexpression was associated with tubule-interstitial inflammation and fibrosis in patients with no clinical or biochemical evidence of pre-RN nephropathy. CONCLUSIONS miR-193b-3p might represent a useful biomarker to tailor and implement surveillance strategies for patients at high risk of developing CKD following RN.
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Affiliation(s)
- Francesco Trevisani
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Ghidini
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Alessandro Larcher
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Lampis
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Hazel Lote
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Paolo Manunta
- Division of Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Genomics of Renal Disease and Hypertension Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Zagato
- Genomics of Renal Disease and Hypertension Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorena Citterio
- Genomics of Renal Disease and Hypertension Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Cristina Carenzi
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Massimo Rugge
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - Paolo Rigotti
- Department of Surgical, Oncological and Gastroenterological Sciences, Kidney and Pancreas Transplantation Unit, University of Padua, Padua, Italy
| | - Roberto Bertini
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luciano Cascione
- Bioinformatics Core Unit, Institute of Oncology Research, Bellinzona, Switzerland
| | - Alberto Briganti
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Fabio Benigni
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Chiara Braconi
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - Jens Claus Hahne
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Francesco Montorsi
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
- Division of Oncology/Unit of Urology; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Nicola Valeri
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
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Xiong C, Liu H, Chen Z, Yu Y, Liang C. Prognostic role of survivin in renal cell carcinoma: A system review and meta-analysis. Eur J Intern Med 2016; 33:102-7. [PMID: 27350406 DOI: 10.1016/j.ejim.2016.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 06/03/2016] [Accepted: 06/08/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Survivin plays an important role in cancer pathogenesis, which has been suggested to be related to poor prognosis in renal cell carcinoma (RCC). We performed a meta-analysis to quantify the prognostic value of survivin in renal cell carcinoma (RCC) patients. PATIENTS AND METHODS Relevant articles exploring the relationship between survivin expression and survival of RCC patients published up to 10 November 2015 were retrieved in PubMed, Web of science and Cochrane databases. The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated by a random-effects model. RESULTS A total of 1583 patients from 10 studies were included. The high expression of survivin was associated with poor Overall Survival (OS) in two studies (Pooled HRs=2.77, 95%CI: 1.46-5.26, I(2)=0.0%, P=0.329). Further, meta-analysis of seven studies showed that elevated survivin expression predicted shorter cancer-specific survival (CSS) of RCC (HR=2.85, 95% CI: 2.25-3.61, I(2)=17.6%, P=0.295). Additionally, subgroup analysis showed that survivin over-expression was associated significantly with worse CSS regardless of different source of survivin, sample size, follow-up duration, race and detection method. CONCLUSIONS A higher survivin expression seems to represent an unfavorable and robust prognostic factor for clinical outcomes in RCC patients.
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Affiliation(s)
- Chaohui Xiong
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Haipeng Liu
- Anhui Provience Children's Hospital, Hefei 230022, China
| | - Zexin Chen
- Department of Clinical Epidemiology & Biostatistics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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Siva S, Jackson P, Kron T, Bressel M, Lau E, Hofman M, Shaw M, Chander S, Pham D, Lawrentschuk N, Wong LM, Goad J, Foroudi F. Impact of stereotactic radiotherapy on kidney function in primary renal cell carcinoma: Establishing a dose-response relationship. Radiother Oncol 2016; 118:540-6. [PMID: 26873790 DOI: 10.1016/j.radonc.2016.01.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 01/31/2016] [Accepted: 01/31/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE To evaluate renal dysfunction after stereotactic ablative body radiotherapy (SABR) for inoperable primary renal cell carcinoma (RCC) using nuclear medicine assessments. MATERIALS AND METHODS In a prospective clinical trial, patients received single fraction renal SABR (26 Gy) for tumours <5 cm, or fractionated SABR (3 × 14 Gy) for tumours ⩾5 cm. Global and regional glomerular filtration rate (GFR) was calculated through (51)Cr-EDTA and (99m)Tc-DMSA SPECT/CT, respectively, at baseline and post-treatment (14, 90 days and at 1-year). Regional loss in function was correlated to the absolute and biologically effective doses (BED) delivered. RESULTS In 21 patients the mean (range) tumour size was 48 mm (21-75 mm). The mean ± SD GFR at baseline was 52 ± 24 ml/min. Net change in mean GFR was +0.6 ± 11.3, +3.2 ± 14.5 and -8.7 ± 13.4 ml/min (p=0.03) at 2 weeks, 3 months and 1 year, respectively. For every 10 Gy of physical dose delivered, an exponential decline in affected kidney GFR was observed at 39% for 26 Gy/1 fraction and 25% for 42 Gy/3 fractions. When normalised to BED3Gy, the dose-response relationship for each treatment prescription was similar with a plateau beyond 100 Gy. The R50% conformity index correlated with GFR loss (p=0.04). No patient required dialysis. CONCLUSIONS SABR results in clinically acceptable and dose-dependent renal dysfunction at 1-year. Sparing functional kidney from high-dose regions (>50% isodoses) may help reduce risk of functional loss.
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Affiliation(s)
- Shankar Siva
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia.
| | - Price Jackson
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia
| | - Tomas Kron
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | - Mathias Bressel
- Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Australia
| | - Eddie Lau
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia; Department of Radiology, University of Melbourne, Australia
| | - Michael Hofman
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | - Mark Shaw
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia
| | - Sarat Chander
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia
| | - Daniel Pham
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia
| | | | - Lih-Ming Wong
- Department of Surgery, University of Melbourne, Australia
| | - Jeremy Goad
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Australia
| | - Farshad Foroudi
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Australia
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Chen Y, Rini BI, Bair AH, Mugundu GM, Pithavala YK. Population pharmacokinetic-pharmacodynamic modelling of 24-h diastolic ambulatory blood pressure changes mediated by axitinib in patients with metastatic renal cell carcinoma. Clin Pharmacokinet 2015; 54:397-407. [PMID: 25343945 DOI: 10.1007/s40262-014-0207-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Increased blood pressure (BP) is commonly observed in patients treated with vascular endothelial growth factor pathway inhibitors, including axitinib. Ambulatory BP monitoring (ABPM) and pharmacokinetic data were collected in a randomised, double-blind phase II study of axitinib with or without dose titration in previously untreated patients with metastatic renal cell carcinoma. OBJECTIVE Aims of these analyses were to (1) develop a population pharmacokinetic-pharmacodynamic model for describing the relationship between axitinib exposure and changes in diastolic BP (dBP) and (2) simulate changes in dBP with different axitinib dosing regimens. METHODS We employed a three-stage modelling approach, which included development of (1) a baseline 24-h ABPM model, (2) a pharmacokinetic model from serial and sparse pharmacokinetic data, and (3) an indirect-response, maximum-effect (Emax) model to evaluate the exposure-driven effect of axitinib on dBP. Simulations (N = 1,000) were performed using the final pharmacokinetic-pharmacodynamic model to evaluate dBP changes on days 4 and 15 of treatment with different axitinib doses. RESULTS Baseline ABPM data from 62 patients were best described by 24-h mean dBP and two cosine terms. The final indirect-response Emax model showed good agreement between observed 24-h ABPM data and population and individual predictions. The maximum increase in dBP was 20.8 %, and the axitinib concentration at which 50 % of the maximal increase in dBP was reached was 12.4 ng/mL. CONCLUSION Our model adequately describes the relationship between axitinib exposure and dBP increases. Results from these analyses may potentially be applied to infer dBP changes in patients administered axitinib at nonstandard doses.
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Affiliation(s)
- Ying Chen
- Pfizer Oncology, Clinical Pharmacology, Pfizer Inc, 10555 Science Center Drive, San Diego, CA, 92121, USA,
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Coyle D, Quinlan MR, D'Arcy FT, Kelly BD, Corcoran O, Durkan GC, Jaffry S, Walsh K, Rogers E. Pattern of Change in Renal Function Following Radical Nephrectomy for Renal Cell Carcinoma. Ir Med J 2015; 108:232-235. [PMID: 26485829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Radical nephrectomy (RN) is an independent risk factor for the development of chronic kidney disease (CKD) in those with renal cell carcinoma (RCC). We aimed to examine the pattern of change in post-operative renal function in patients who underwent RN for RCC over a 3 year period at our institution. We performed a retrospective review of histological and biochemical findings in patients undergoing RN for RCC over a 38 month period. Estimated glomerular filtration rate (eGFR) was recorded pre- and post-operatively and at follow-up. We analysed data on 131 patients (median follow-up 24 months). The proportion of patients with advanced CKD increased significantly at follow-up with 48 (85.7%) patients, classified as having stage 2 CKD pre-operatively, being re-classified as stage 3-5. Mean eGFR was significantly lower pre-operatively (76.6 mL/min/1.73 m2) compared to hospital discharge (61 mL/min/1.73 m2, p < 0.001) and follow-up (55.5 mL/min/1.73 m2, p < 0.001). Those with pT1 tumours sustained a significantly greater decline in eGFR compared to other stages. In conclusion, patients with pT1 a and pT1 b tumours sustain a disproportionate decline in renal function and may benefit the most from NSS.
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Anand D, Escalante CP. Ongoing Screening and Treatment to Potentially Reduce Tyrosine Kinase Inhibitor-Related Fatigue in Renal Cell Carcinoma. J Pain Symptom Manage 2015; 50:108-17. [PMID: 25701692 DOI: 10.1016/j.jpainsymman.2015.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 01/20/2015] [Accepted: 02/02/2015] [Indexed: 01/03/2023]
Abstract
CONTEXT Renal cell carcinoma (RCC) represents 1% to 4% of adult malignancies, and approximately 33% of patients with RCC present with metastatic disease and have a poor prognosis. Better understanding of RCC tumor biology has led to the development of several molecularly targeted agents, such as tyrosine kinase inhibitors (TKIs), to manage advanced disease. Although evolving data suggest these drugs may be beneficial in RCC, they are associated with significant toxicities. Cancer-related fatigue (CRF) is one of the most common toxicities associated with the TKIs used in RCC. OBJECTIVES To review the incidence, pathophysiology, and management of CRF in patients with RCC who are undergoing targeted therapy with TKIs. METHODS A comprehensive database search was performed using PubMed, Ovid, Embase, and MEDLINE. References of all cited articles also were reviewed. Data from articles published between 1975 and June 2014 were considered. A narrative review regarding the incidence, pathophysiology, and management of CRF in patients with RCC undergoing targeted therapy with TKIs was performed. RESULTS CRF is one of the most common TKI toxicities in patients with metastatic RCC and often is the dose-limiting toxicity. Management of TKI-related CRF can be difficult and may necessitate various nonpharmacologic and pharmacologic interventions. CONCLUSION TKI-related CRF in patients with RCC is a highly distressing complication of cancer therapy. CRF can substantially influence drug compliance, the ability to maximally treat, and quality of life. It is important to recognize this common, yet frequently underdiagnosed complication and initiate appropriate management strategies, to increase the likelihood for optimal outcomes.
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Affiliation(s)
- Deepa Anand
- Department of General Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Carmen P Escalante
- Department of General Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
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Gu C, Zhang H, Dai B, Zhu Y, Shi G, Shen Y, Qu Y, Wan F, Zhang G, Ye D. [Comparison of the renal function after partial nephrectomy and radical nephrectomy for T1a renal cell carcinoma]. Zhonghua Zhong Liu Za Zhi 2015; 37:441-444. [PMID: 26463148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the alterations in renal function after radical nephrectomy (RN) and partial nephrectomy (PN) for renal cell carcinoma (RCC) and to determine the risk factors for the onset of postoperative renal function impairment. METHODS We assessed the renal function of 429 T1a RCC patients by investigating the time-dependent changes of the estimated glomerular filtration rate (eGFR) after surgery from August 2003 to August 2010. Univariate and multivariate regression models were used to determine the risk factors for the onset of an eGFR < 60 ml · min⁻¹ · 1.73 m⁻² function, and to evaluate the prognosis for the two groups. RESULTS The mean eGFR values (ml · min⁻¹ · 1.73 m⁻²) at postoperative 1, 7 days, 1, 3, 6, 12 and 24 months were 51.4 ± 12.6, 52.1 ± 17.8, 53.2 ± 19.5, 54.6 ± 20.2, 53.8 ± 16.6, 52.7 ± 22.3 and 51.5 ± 18.4 in the RN group and 69.6 ± 18.3, 70.3 ± 19.5, 71.5 ± 21.4, 76.2 ± 22.8, 75.4 ± 19.7, 74.3 ± 16.3 and 73.1 ± 23.2 in the PN group, respectively. The eGFR of the radical nephrectomy group was significantly lower than that of the partial nephrectomy group (P < 0.05). Multivariable analysis revealed that radical nephrectomy and age were risk factors for the onset of postoperative chronic renal dysfunction. CONCLUSIONS Renal function recovered partially after partial and radical nephrectomy and is maintained constantly after 3 months. Surgical mode and age are risk factors for the onset of postoperative eGFR < 60 ml · min⁻¹ · 1.73 m⁻² impairment. Compared with radical nephrectomy, partial nephrectomy can preserve renal function and reduce the incidence of postoperative chronic renal dysfunction.
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Affiliation(s)
- Chengyuan Gu
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Hailiang Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Bo Dai
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Guohai Shi
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yijun Shen
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yuanyuan Qu
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Fangning Wan
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Guiming Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China;
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Lake M, Tanawuttiwat T, Bilsker M, De Marchena E. Hemodynamic evaluation of suspected severe aortic stenosis leads to a diagnosis of renal cell carcinoma. Tex Heart Inst J 2015; 42:77-9. [PMID: 25873807 DOI: 10.14503/thij-13-3925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The evaluation of aortic stenosis is not always straightforward. When symptoms of severe aortic stenosis are present with supporting Doppler echocardiographic or cardiac catheterization data, replacement of the aortic valve is recommended. Occasionally, Doppler- and catheter-derived data are discordant; appropriate treatment in such cases becomes less clear. We report a case in which a 66-year-old man's symptoms and Doppler data suggested severe aortic stenosis. However, heart catheterization data suggested otherwise, and ultimately it led to the diagnosis of a highly vascular renal tumor. Shunting within the tumor resulted in high cardiac output, which, in combination with a small aortic root, masqueraded as severe aortic stenosis.
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Chung JS, Son NH, Lee SE, Hong SK, Lee SC, Kwak C, Hong SH, Kim YJ, Kang SH, Byun SS. Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma: a propensity-matched multicentre study. Eur J Cancer 2015; 51:489-497. [PMID: 25576517 DOI: 10.1016/j.ejca.2014.12.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/01/2014] [Accepted: 12/14/2014] [Indexed: 01/23/2023]
Abstract
BACKGROUND This study aimed to evaluate the overall survival (OS) rate and renal function after radical nephrectomy (RN) and partial nephrectomy (PN) in patients aged ⩾65years. METHODS Patients who underwent RN (n=622) or PN (n=622) for renal cell carcinoma (pT1N0M0) between 1999 and 2011 were propensity-score matched in our multicentre database. To investigate the relative effect of PN on OS according to age, we divided the patients into two age subgroups (<65 and ⩾65years). The 5-year OS rates and probabilities of freedom from chronic kidney disease (CKD III or IV) were estimated using the Kaplan-Meier method and separate Cox proportional hazards models. RESULTS The 5-year OS rates after surgery were 94.7% for PN and 91.9% for RN in the older patients (P=0.698). The corresponding rates in the younger patients were 99.7% for PN and 96.3% for RN (P=0.015). In separate Cox hazards models for OS, the older patients who underwent PN were not significantly different from their RN-treated counterparts (hazard ratio (HR): 0.960; 95% confidence interval (CI): 0.277-2.321, P=0.797). Kidney function was significantly better preserved after PN than after RN at all ages. However, stage IV CKD in the older patients did not occur more frequently in the RN arm than in the PN arm. CONCLUSIONS Although PN was associated with improved renal function compared with RN, it did not confer a benefit of higher survival rate in elderly patients (⩾65yearsold).
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Affiliation(s)
- Jae Seung Chung
- Department of Urology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Nak Hoon Son
- Department of Biostatistics, Yonsei University, Seoul, Republic of Korea
| | - Sang Eun Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sang Chul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Yong June Kim
- Department of Urology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Kim CS, Bae EH, Ma SK, Kweon SS, Kim SW. Impact of partial nephrectomy on kidney function in patients with renal cell carcinoma. BMC Nephrol 2014; 15:181. [PMID: 25410757 PMCID: PMC4246517 DOI: 10.1186/1471-2369-15-181] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 11/10/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aimed to compare the changes in kidney function and the association of tumor size and renal outcomes between patients with renal cell carcinoma (RCC) who underwent radical nephrectomy (RN) and those who underwent partial nephrectomy (PN). METHODS A retrospective cohort study was conducted for 557 patients with an RCC of ≤7 cm in diameter and normal contralateral kidney function who underwent PN or RN. PN was performed for 218 (39%) patients. Renal outcomes included the incidence of acute kidney injury (AKI), new-onset chronic kidney disease (CKD), and a ≥25% decline in eGFR 1 year after surgery. RESULTS Serial changes in eGFR were compared during the 3 years of follow-up. Postoperative eGFR was significantly lower in patients undergoing RN than in those undergoing PN. The incidence of AKI and new-onset CKD was significantly higher in patients after RN (70.1% vs. 24.3%, respectively; P<0.001) than after PN (55.7% vs. 6.2%, respectively; P<0.001). According to the multivariable logistic regression analysis, RN was an independent risk factor for a ≥25% decline in kidney function after 1 year regardless of the tumor size, even after adjusting for various covariates. CONCLUSIONS Compared to PN, RN for even a moderate sized RCC leads to an increased incidence of AKI and new-onset CKD, and is a significant risk factor for kidney function decline. Therefore, PN should be considered as the choice of surgical treatment for RCCs that are ≤7 cm in diameter in order to preserve renal function postoperatively.
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Affiliation(s)
- Chang Seong Kim
- />Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757 Korea
| | - Eun Hui Bae
- />Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757 Korea
| | - Seong Kwon Ma
- />Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757 Korea
| | - Sun-Seog Kweon
- />Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
- />Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
| | - Soo Wan Kim
- />Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757 Korea
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Cella D, Davis MP, Négrier S, Figlin RA, Michaelson MD, Bushmakin AG, Cappelleri JC, Sandin R, Korytowsky B, Charbonneau C, Matczak E, Motzer RJ. Characterizing fatigue associated with sunitinib and its impact on health-related quality of life in patients with metastatic renal cell carcinoma. Cancer 2014; 120:1871-80. [PMID: 24634003 PMCID: PMC4231253 DOI: 10.1002/cncr.28660] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/24/2014] [Accepted: 02/10/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND Using phase 3 trial data for sunitinib versus interferon (IFN)-α in treatment-naive patients with metastatic renal cell carcinoma, retrospective analyses characterized sunitinib-associated fatigue and its impact on patient-reported health-related quality of life (HRQoL). METHODS Patients received sunitinib at a dose of 50 mg/day on a schedule of 4 weeks on/2 weeks off (375 patients) or IFN-α at a dose of 9 MU subcutaneously 3 times per week (360 patients). HRQoL was self-assessed using the Functional Assessment of Cancer Therapy-Kidney Symptom Index-15-item (FKSI-15) questionnaire, with fatigue assessed using its Disease-Related Symptoms subscale. Fatigue was also assessed by providers using Common Terminology Criteria for Adverse Events (CTCAE). A repeated-measures model (M1) and random intercept-slope model (M2) characterized sunitinib-associated fatigue over time. Another repeated-measures model examined the relationship between HRQoL scores and CTCAE fatigue grade. RESULTS M1 demonstrated that the initial increase in patient-reported fatigue with sunitinib was worst during cycle 1, with mean values numerically better at subsequent cycles; most pairwise comparisons of consecutive CTCAE fatigue cycle means were not found to be statistically significant. M2 demonstrated that the overall trend (slope) for patient-reported and CTCAE fatigue with sunitinib was not statistically different from 0. The relationship between most HRQoL scores and CTCAE fatigue was close to linear regardless of treatment, with lower scores (worse HRQoL) corresponding to higher fatigue grade. The majority of HRQoL scores were better with sunitinib versus IFN-α for the same CTCAE fatigue grade. CONCLUSIONS Patients reported worse fatigue during the first sunitinib cycle. However, in subsequent consecutive cycles, less fatigue was reported with no statistically significant worsening. CTCAE fatigue assessment may not fully capture patient treatment experience.
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Affiliation(s)
- David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of MedicineChicago, Illinois
| | | | | | - Robert A Figlin
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical CenterLos Angeles, California
| | - M Dror Michaelson
- Genitourinary Cancer Center, Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Rickard Sandin
- Global Health Economics and Outcomes Research, Pfizer OncologySollentuna, Sweden
| | - Beata Korytowsky
- Global Health Economics Outcomes Research, Pfizer OncologyNew York, New York
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Rao Q, Xia QY, Shen Q, Shi SS, Tu P, Shi QL, Zhou XJ. Coexistent loss of INI1 and BRG1 expression in a rhabdoid renal cell carcinoma (RCC): implications for a possible role of SWI/SNF complex in the pathogenesis of RCC. Int J Clin Exp Pathol 2014; 7:1782-1787. [PMID: 24817979 PMCID: PMC4014263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 02/23/2014] [Indexed: 06/03/2023]
Abstract
In this study, we analyzed the immunohistochemical and molecular profiles of an unusual RCC showed coexistent absence of INI1 and BRG1 expression, rhabdoid morphology, and poor prognosis. Histologically, the tumor had rhabdoid features, which were demonstrated by large round to polygonal cells with eccentric nuclei, prominent nucleoli, and eosinophilic cytoplasm varying from abundant to scanty. Immunohistochemically, the tumor were positive for BRM, PBRM1, ARID1A, CD10, CKpan, Vimentin, carbonic anhydrase IX (CA-IX), and P504S (AMACR) but negative for INI1, BRG1, HMB45, melan A, CK7, CD117, Ksp-cadherin, TFEB, TFE3, and Cathepsin K. We detected all three exons status of the VHL gene of the tumor and observed 1 somatic mutations in 1st exon. Chromosome 3p deletion, coupled with polysomy of chromosome 3 was also found. Based on these findings, it is further indicated that in some cases, rhabdoid RCC may arise from clear cell RCC. SWI/SNF chromatin remodeling complex may be an attractive candidate for being the "second hit" in RCCs and may play an important role during tumor progression. The role of SWI/SNF complex in rhabdoid RCC should be further studied on a larger number of cases.
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Affiliation(s)
- Qiu Rao
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
| | - Qiu-Yuan Xia
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
| | - Qin Shen
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
| | - Shan-Shan Shi
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
| | - Pin Tu
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
| | - Qun-Li Shi
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
| | - Xiao-Jun Zhou
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine Nanjing, China
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Curry D, Yassin M, Thwaini A, Pahuja A, Alanbuki AH, Rajan TN, Loan W. Radiofrequency ablation of renal cell carcinoma: a follow up of outcomes. Can J Urol 2014; 21:7135-7140. [PMID: 24529016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION To present the oncological outcomes in a series of patients with cT1a renal cell carcinoma (RCC) treated with radiofrequency ablation (RFA) and its effect on the glomerular filtration rate (GFR). MATERIALS AND METHODS Forty-five patients (48 renal units) treated at the Belfast City Hospital, over 4 years. Average age is 61.5 years (range 41-80). Eighteen patients (22 renal units) were included with American Society of Anesthesiologists (ASA) II and III. The rest were ASA I. Average tumor size was 2.63 cm (range 1.2 cm-6 cm). Renal function before and after RFA was recorded by means of the estimated glomerular filtration rate (eGFR) and the changes are presented. Oncological outcomes were established from follow up imaging. A satisfactory response was defined by disappearance or a persistence of non-enhancing lesion of smaller size at follow up. A partial response was defined by a persistent but non-enhancing similar size lesion. A failed response was defined by enlarging or persistently enhancing lesions. RESULTS Mean follow up was 30.6 months (4-60 months). A good response was found in 33 (74%) patients. A partial response was found in 3 (8%) patients and failed response was identified in 8 (18%) patients. The average reduction in eGFR was 11 mL/min. Two patients had a 50% reduction in their eGFR. No patient required dialysis following treatment. CONCLUSION RFA presents safe treatment choice for patients with RCC, particularly those that are high risk surgical candidates and those who refuse surgery. Short term results suggest good oncological outcomes and preservation of renal function.
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Affiliation(s)
- David Curry
- Belfast City Hospital, Belfast, Northern Ireland
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Abstract
This review summarizes the safety of sorafenib, an oral multikinase inhibitor, focusing on the randomized, placebo-controlled, Phase III Treatment Approaches in Renal Cancer Global Evaluation Trial (TARGET) in renal cell carcinoma, which formed the basis of the approval of sorafenib. Similar to other targeted agents, sorafenib acts primarily to induce disease stabilization, rather than tumor regression, suggesting that long-term administration is necessary. The tolerability of an agent is important in long-term treatment, and a predictable and manageable side-effect profile is advantageous. Although IL-2 and interferon have been standard care treatments for advanced renal cell carcinoma for over a decade, they are poorly tolerated. Targeted agents offer an alternative for patients with advanced renal cell carcinoma, as initial therapy or after failure of cytokine treatment.
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Affiliation(s)
- Thomas E Hutson
- Baylor University Medical Center, GU Oncology Program, Texas Oncology, PA, Sammons Cancer Center, 3535 Worth Street, Dallas TX 75246, USA.
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Abstract
The term maintenance immunotherapy comprises at least two different therapeutic approaches: the continuation of immunotherapy beyond disease progression and the use of chronic immunotherapy after the achievement of an initial response (or disease stabilization) with more intensive treatment modalities, such as chemotherapy. The former therapeutic approach was proposed in renal cell carcinoma some years ago relying on several immunological considerations. Some years later, we have learned that it is feasible and endowed with a favorable therapeutic index; furthermore, its immunologic effects are well described and reproducible, and it has antitumor activity. However, due to the lack of adequate randomized Phase III studies, the actual impact of this treatment strategy on patient survival has not yet been proved. The rationale of this treatment, its immunological and clinical results, as well as its pitfalls and perspectives, will be presented and discussed in this review.
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Affiliation(s)
- Camillo Porta
- Medical Oncology and Laboratory of Preclinical Oncology and Developmental Therapeutics, IRCCS San Matteo University Hospital, Piazzale Camillo Golgi, 2I-27100 Pavia, Italy.
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Belov IV, Komarov RN, Cherniavskiĭ SV, Dziundzia AN, Kholod IS. [Radical surgery in renal cell carcinoma with tumor thrombosis of the inferior vena cava and right atrium with cardiopulmonary bypass]. Khirurgiia (Mosk) 2014:76-78. [PMID: 25327681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Kajmaković BM, Džamić ZM, Dragicević S, Aćimović M, Milojević B, Djokić JH. A case report of the first laparoscopic radical nephrectomy done at the Clinic of Urology, Clinical Centre of Serbia. Acta Chir Iugosl 2014; 61:107-111. [PMID: 25782237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Laparoscopic interventions are at the very beginning of its evolution in the Clinic of Urology. The first steps have been made primarily to cope with problem of varicocele. We continued to gain laparoscopic experience by switching to solving some demanding intervention, primarily kidney cyst. The only logical next step lead to laparoscopic renal surgery. So, after a few successful primary simple nephrectomy, the next step was to perform a laparoscopic radical nephrectomy. Today, at the Clinic of Urology, Clinical Center of Serbia we successfully perform much more demanding interventions, such as extraperitoneal laparoscopic radical prostatectomy. In this paper we present our experience with the first laparoscopic radical nephrectomy, which was done at the Clinic of Urology, Clinical Center of Serbia.
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Affiliation(s)
- Yi Xie
- Departments of Urology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai-Fu-Yuan, Wang-Fu-Jing, Beijing 100730, China.
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Nair VJ, Szanto J, Vandervoort E, Cagiannos I, Breau R, Malone C, Avruch L, Pantarotto J, Malone S. CyberKnife for inoperable renal tumors: Canadian pioneering experience. Can J Urol 2013; 20:6944-6949. [PMID: 24128835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Stereotactic ablative body radiotherapy (SABR) is currently under study regarding its clinical application in management of patients with kidney tumors. CyberKnife can accurately deliver ablative tumor radiation doses while preserving kidney function. We report Canada's first use of CyberKnife SABR system in treating primary kidney tumors. MATERIALS AND METHODS Between January 2011 and February 2012, we treated three patients with renal tumors using CyberKnife SABR. Two patients had tumors in solitary kidney. The third patient had a recurrent tumor after two previous radiofrequency ablation treatments. Platinum seed fiducials were used for real time tumor tracking. Magnetic resonance imaging registration was used for tumor delineation in all cases. The patients were followed with regular renal scans and renal function tests. RESULTS The mean age was 79 years. Mean tumor size was 21.3 cm3. A dose of 39 Gy in 3 fractions was delivered. The post treatment follow up times were 15 months, 13 months and 12 months. Local control was obtained in all three patients. No acute or chronic toxicity was reported. Kidney functions remained unaffected after treatment. CONCLUSION CyberKnife is technically feasible for treatment of medically inoperable renal tumors or tumors in a solitary kidney.
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Affiliation(s)
- Vimoj J Nair
- University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
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Perlin DV, Aleksandrov IV, Zipunnikov VP, Kargin KA. [Laparoscopic partial nephrectomy using local ischemia]. Urologiia 2013:69-73. [PMID: 24159770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Oncological outcomes of laparoscopic partial nephrectomy are no worse than those after open sparing operation for kidney cancer. However, laparoscopic procedures are accompanied by a longer warm ischemia. In order to reduce the ischemic injury, local ischemia by isolation and temporary clamping of the individual branches of the renal artery was used. From January 2009 to June 2012, 60 laparoscopic partial nephrectomies were performed in the clinic, including 34 resections with temporary clipping of renal artery and 26 resections with temporary clipping of secondary and tertiary segmental and subsegmental branches. Functions of affected kidney were evaluated before and after surgery in both groups of patients. At 3 months after surgery, significantly lower decline of the function of affected kidney was observed in patients who underwent resection with the use of local ischemia compared with patients who received the intervention accompanied by a temporary clamping the renal artery. Partial nephrectomy using local ischemia can significantly expand the indications for laparoscopic and retroperitoneoscopic sparing operation for renal cell cancer.
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