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Abramson Cancer CenterNCI CANCERLIT® Search: Kidney (Renal Cell) Cancer - July 2002
National Cancer Institute®
Last Modified: July 1, 2002
- Nonmyeloablative conditioning followed by hematopoietic cell allografting and donor lymphocyte infusions for patients with metastatic
- Intracavitary therapy of noninvasive transitional cell carcinomas of the upper urinary tract. A review of the literature.
- Role of percutaneous image-guided biopsy in the evaluation of renal masses.
- Imperative indications for conservative surgery for renal cell carcinoma: 20 years' experience.
- Differentiation of subtypes of renal cell carcinoma on helical CT scans.
- [A clinicopathological study of clear cell sarcoma of the kidney]
- Anatomic landmarks and time management during retroperitoneoscopic radical nephrectomy.
- Risk factors for adult renal cell carcinoma: a systematic review and implications for prevention.
- Risk factors for adult renal cell carcinoma: a systematic review and implications for prevention.
- Expression of HGF/SF and Met protein is associated with genetic alterations of VHL gene in primary renal cell carcinomas.
- Expression of matrix metalloproteinase in the fluids of renal cystic lesions.
- The endourological management of complications associated with horseshoe kidney.
- Biological significance of c-met over expression in papillary renal cell carcinoma.
- The influence of pNx/pN0 grouping in a multivariate setting for outcome modeling in patients with clear cell renal cell carcinoma.
- Bilateral renal oncocytosis with renal failure.
- Role of the von Hippel-Lindau tumor suppressor gene in the formation of beta1-integrin fibrillar adhesions.
- Expression of hypoxia-inducible factors in human renal cancer: relationship to angiogenesis and to the von Hippel-Lindau gene mutation.
- [Surgical treatment for metastatic renal cell tumors of the lung]
- Localization of urotensin-II immunoreactivity in normal human kidneys and renal carcinoma.
- [Guideline for proper use of antineoplastic agents. Urologic cancer]
- Expression profiling of renal epithelial neoplasms: a method for tumor classification and discovery of diagnostic molecular markers.
- Ultrasound of renal tumors.
- Fast sequences with fat suppression in breath-hold mode: new standard in contrast-enhanced T1-weighted MR imaging of renal tumors?
- Guidelines on renal cell cancer.
- Upper tract transitional cell carcinoma following cystectomy for bladder cancer.
- Familial and sporadic renal oncocytomas--a comparative molecular-genetic analysis.
- Color Duplex sonography vs. computed tomography: accuracy in the preoperative evaluation of renal cell carcinoma.
- VHL-mediated hypoxia regulation of cyclin D1 in renal carcinoma cells.
- Induction and regulation of tumor necrosis factor-related apoptosis-inducing ligand/Apo-2 ligand-mediated apoptosis in renal cell
- Advanced renal cell carcinoma.
- Localized renal cell carcinoma.
- Axin, the main component of the Wnt signaling pathway, is not mutated in kidney tumors in children.
- [Kidney tumors]
- A population-based familial aggregation analysis indicates genetic contribution in a majority of renal cell carcinomas.
- Clinical pathways for managing patients receiving interleukin 2.
- Intragenic PTEN/MMAC1 loss of heterozygosity in conventional (clear-cell) renal cell carcinoma is associated with poor patient
- Preemptive analgesia: no relevant advantage of preoperative compared with postoperative intravenous administration of morphine, ketamine, and
- Radiofrequency ablation used to treat select renal and adrenal tumors.
- Advanced renal cell carcinoma.
- MUC1 expression is correlated with nuclear grade and tumor progression in pT1 renal clear cell carcinoma.
- Re: Port site tumor recurrences of renal cell carcinoma after videolaparoscopic radical nephrectomy.
- Nephron-sparing surgery.
- Laparoscopic nephrectomy for renal cell carcinoma.
- Dendritic cell-based immunotherapy of renal cell carcinoma.
- Molecular-based therapies for renal cell carcinoma.
- Should laparoscopy be the standard approach used for radical nephrectomy?
- hOGG1 gene alterations in human clear cell carcinomas of the kidney: effect of single mutations in hOGG1 gene on substrate specificity of the
- Initial experience of percutaneous renal cryosurgery under the guidance of a horizontal open MRI system.
- Adrenal metastasis from renal cell carcinoma: significance of adrenalectomy.
- Distinct in vivo expression patterns of survivin splice variants in renal cell carcinomas.
- Cyclin D3 protein content in human renal cell carcinoma in relation to cyclin D1 and clinico-pathological parameters.
- Vascular endothelial growth factor overexpression is correlated with von Hippel-Lindau tumor suppressor gene inactivation in patients with
- [Systematic conservative surgery for kidney cancer smaller than 4 cm: multicenter study]
- Carcinogenicity of trichloroethylene.
- Renal metastasis.
- Prognostic impact of extensive parenchymal invasion pattern in pT3 renal pelvic transitional cell carcinoma.
- [Renal conservative surgery with selective renal parenchymal clamping]
- GlycoDesign expands phase II clinical trials for GD0039.
- Pentostatin effective as preparative regimen for kidney transplants.
- New agents for the treatment of renal cell carcinoma.
- Prognostic factors and molecular markers for renal cell carcinoma.
- Evolving classification of renal cell neoplasia.
Table of Contents
1
UI - 12010834
AU - Bregni M; Dodero A; Peccatori J; Pescarollo A; Bernardi M; Sassi I;
TI -
Voena C; Zaniboni A; Bordignon C; Corradini P
Nonmyeloablative conditioning followed by hematopoietic cell
allografting and donor lymphocyte infusions for patients with metastatic
renal and breast cancer.
SO - Blood 2002 Jun 1;99(11):4234-6
AD - Bone Marrow Transplant Unit and Gene Therapy Program and the Division of
Pathology, Istituto H San Raffaele, Milano, Italy. marco.bregni@hsr.it
The feasibility and toxicity of allogeneic stem cell transplantation
after nonmyeloablative conditioning including thiotepa, fludarabine, and
cyclophosphamide have been investigated in 6 patients with breast cancer
and 7 patients with renal cell cancer. The program included the use of
escalating doses of donor lymphocyte infusions (DLI) and/or interferon
alpha (IFNalpha) for patients showing no tumor response and no
graft-versus-host disease (GVHD). Patients were at high risk of
transplant-related mortality (TRM) because of age, advanced stage, and
previous treatments. We observed a partial remission in 4 renal cancer
and in 2 breast cancer patients (one at the molecular level in the bone
marrow), occurring after cyclosporine withdrawal or after DLI and/or
IFNalpha. All the responses were accompanied by the occurrence of acute
GVHD. We conclude that reduced-intensity allogeneic stem cell
transplantation is a feasible procedure in renal and breast cancer, and
that the exploitation of graft-versus-tumor effect after DLI is a
promising finding.
2
UI - 11598443
AU - Bassi P; Iafrate M; Longo F; Iannello A; Mostaccio G; Ingrassia A;
TI -
Repele M; Tavolini IM
Intracavitary therapy of noninvasive transitional cell carcinomas of the
upper urinary tract. A review of the literature.
SO - Urol Int 2001;67(3):189-94
AD - Department of Urology, University of Padua Medical School, Via
Giustiniani, 2, I-35128 Padua, Italy. bassipf@unipd.it
Noninvasive (stages Ta, T1, Tis) transitional cell carcinomas of the
upper urinary tract are suitable for a conservative therapeutic
approach. Intracavitary therapy (alone or as adjuvant treatment) has
recently been proposed and successfully used by some authors. Even
though bacillus Calmette-Guerin is the most frequent agent employed,
chemotherapeutic drugs, such as mitomycin C and thiotepa, have also been
successfully used. The current information available in the literature
is therefore reviewed. According to the data available, intracavitary
therapy is a worthwhile conservative therapeutic option for noninvasive
upper urinary tract urotheliomas with acceptable side effects. For this
reason it may be included in the routine urological armamentarium.
3
UI - 11598445
AU - Hara I; Miyake H; Hara S; Arakawa S; Hanioka K; Kamidono S
TI -
Role of percutaneous image-guided biopsy in the evaluation of renal
masses.
SO - Urol Int 2001;67(3):199-202
AD - Department of Urology, Kobe University School of Medicine, 7-5-1
Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
OBJECTIVE: The objective of the present study was to evaluate the
indications, accuracy, complications and impact of image-guided
percutaneous biopsy of renal masses. MATERIALS AND METHODS: Between 1994
and 1999, percutaneous biopsies under ultrasonography or computerized
tomography guidance were performed in 33 patients with renal mass (22
men and 11 women, mean age 57.5 years, range 21-88). We retrospectively
analyzed the relationship between clinical and histopathological
findings, and discuss the appropriateness of the indications for
image-guided percutaneous biopsy in the diagnosis of renal masses.
RESULTS: The indications used in our institution were as follows: (1)
clinical and radiological findings to suggest a diagnosis other than
primary renal cell carcinoma (RCC) (n = 15); (2) suspicious lesions of
RCC in multiple cystic renal masses (n = 7); (3) differentiation of
transitional cell carcinoma of the renal pelvis from RCC (n = 7); (4)
differentiation of angiomyolipoma from RCC (n = 4). Sufficient amounts
of tissues were obtained from all patients for pathological diagnosis.
Among 33 patients, 21 (63.6%) were diagnosed positive for malignancy,
and 15 underwent surgical intervention. The histopathological findings
between percutaneous biopsy and surgically resected tissue were
identical in 13 cases (86.7%). No patient developed major complications
requiring surgical treatment. CONCLUSION: If performed under appropriate
selection of patients, percutaneous image-guided biopsy is a safe,
reliable and accurate method of managing suspicious and/or indeterminate
renal mass, and may contribute to the selection of appropriate clinical
management by avoiding unnecessary procedures. Copyright 2001 S. Karger
AG, Basel
4
UI - 11598446
AU - Gacci M; Rizzo M; Lapini A; Serni S; Stefanucci S; Carini M
TI -
Imperative indications for conservative surgery for renal cell
carcinoma: 20 years' experience.
SO - Urol Int 2001;67(3):203-8
AD - Department of Urology, University of Florence, Viale Pieraccini 18,
I-50139 Florence, Italy.
INTRODUCTION: Radical nephrectomy is the treatment of first choice for
unilateral renal cell carcinoma (RCC) with a healthy contralateral
kidney; however, the current standard for dealing with RCC in patients
with a solitary kidney, bilateral tumor and renal or systemic disease
inducing a progressive impairment of renal function is nephron-sparing
patients (39 men and 23 women, 33-77 years old, mean age 60.6 years)
with RCC underwent nephron-sparing surgery. The patients were divided in
to two groups according to treatment indication: 46 patients with
bilateral tumor (n = 21) or solitary kidney (n = 25) and 16 patients
with renal or systemic disease that could damage the contralateral
kidney. Survival curves were calculated according to the Kaplan-Meyer
method. RESULTS: In the first group 3 patients died postoperatively, and
3 were lost to follow-up; 12 patients (27.9%) had malignant recurrence
and 5 (11.6%) died of local recurrence or systemic diffusion. The
probability of local or systemic tumor recurrence was 9.9% at 2 years,
20.2% at 5 years and 24.7% at 10 years; the probability of survival was
100% at 2 years, 91.9% at 5 years and 81.9% at 10 years. In the second
group 3 patients died of unrelated causes and 1 was lost to follow-up; 4
patients (25%) had a malignant recurrence and 2 (12.5%) died of systemic
diffusion of RCC. The probability of tumor recurrence was 13.0% at 2
years, 19.7% at 5 years and 26.4% at 10 years, the probability of
survival was 100% at 2 years, 93.3% at 5 years and 86.1% at 10 years.
CONCLUSIONS: In our experience nephron-sparing surgery seems justified
in patients with a solitary kidney, bilateral tumor or a disease that
potentially damages renal function. Tumor diameter and stage, incidental
or symptomatic tumor presentation and specific indication for
conservative surgery determine the prognosis. Copyright 2001 S. Karger
AG, Basel
5
UI - 12034628
AU - Kim JK; Kim TK; Ahn HJ; Kim CS; Kim KR; Cho KS
TI -
Differentiation of subtypes of renal cell carcinoma on helical CT scans.
SO - AJR Am J Roentgenol 2002 Jun;178(6):1499-506
AD - Department of Radiology, Asan Medical Center, University of Ulsan, 388-1
Poongnap-dong, Songpa-gu, Seoul, 138-736, South Korea.
OBJECTIVE: The purpose of our study was to differentiate subtypes of
renal cell carcinoma on helical CT scans. MATERIALS AND METHODS: We
reviewed CT scans of four subtypes of renal cell carcinoma: 76
conventional (clear cell), 19 papillary, 13 chromophobe, and two
collecting duct. Biphasic CT scans (unenhanced, corticomedullary, and
excretory phase scans) were obtained in 61 patients, and monophasic CT
scans (unenhanced and excretory phase scans) in 49. We compared patient
age and sex; tumor size; degree and pattern (homogeneous, heterogeneous,
predominantly peripheral) of enhancement; presence or absence of
calcification; and tumor-spreading patterns including perinephric
change, venous invasion, and lymphadenopathy in four subtypes. RESULTS:
Conventional renal carcinoma showed stronger enhancement than the other
subtypes (p < 0.05): 106 +/- 48 H (mean +/- SD) in the corticomedullary
phase and 62 +/- 25 H in the excretory phase. The sensitivity and
specificity for differentiating conventional renal carcinoma from the
other subtypes were 74% and 100% when 84 H was used as the cutoff value
in the corticomedullary phase and 84% and 91% when 44 H was used as the
cutoff value in the excretory phase. Conventional (84%), papillary
(74%), and collecting duct (100%) renal carcinomas tended to show
heterogeneous or predominantly peripheral enhancement, whereas
chromophobe renal carcinoma (69%) usually showed homogeneous
enhancement. Calcification was more common in papillary (32%) and
chromophobe (38%) renal carcinomas than in conventional renal carcinoma
(11%) (p < 0.05). Perinephric change and venous invasion were not noted
in chromophobe renal carcinoma, whereas both were common in collecting
duct renal carcinoma. CONCLUSION: For the differentiation of the
subtypes of renal cell carcinoma, degree of enhancement is the most
valuable parameter; enhancement pattern, the presence or absence of
calcification, and tumor-spreading patterns can serve supplemental roles
in the identification of the subtype of renal cell carcinoma.
6
UI - 11866983
AU - He L; Fu L; Wang L; Li P; Lang Z
TI -
[A clinicopathological study of clear cell sarcoma of the kidney]
SO - Zhonghua Bing Li Xue Za Zhi 2001 Dec;30(6):422-5
AD - Department of Pathology, Beijing Children's Hospital, Beijing 100045,
China.
OBJECTIVE: To study the clinicopathological, immunohistochemical
features and the histogenesis of clear cell sarcoma of the kidney
(CCSK). METHODS: CCSK specimens from 45 pediatric cases, including 31
male and 14 female with an age range from 3 months to 12 years (mean of
3.2 years), were retrieved. Routine pathological, immunohistochemical
and electron microscopic methods were utilized to analyze the CCSK
specimens. RESULTS: 35 of the 45 cases were followed from 6 to 192
months. 15 patients presented with bone metastases, 6 had lung or liver
metastases, 8 recurred and 20 died. Age and clinical stage at diagnosis
correlated with the rate of survival. Histologically, the classic
pattern of CCSK consisted of cells with pale cytoplasm, fine nuclear
chromatin and indistinct nucleoli separated by an arborizing
fibrovascular stroma. Other patterns were identified, including myxoid,
spindle, palisading, epithelioid, sclerosing, cellular, cystic, and
angiectatic. All tumors contained multiple patterns.
Immunohistochemically, all cases were positive for vimentin, but
negative for EMA, CK, desmin, actin, S-100, NSE, CD99, CD34 and LCA.
Electron microscopy of 9 cases showed features of primitive cell
conjunction and few organelles. CONCLUSION: CCSK is a common renal
neoplasm of childhood. CCSK may arise from renal mesenchymal cells and
has the propensity to metastasize to the bone with poor clinical
outcome.
7
UI - 12028626
AU - Sung GT; Gill IS
TI -
Anatomic landmarks and time management during retroperitoneoscopic
radical nephrectomy.
SO - J Endourol 2002 Apr;16(3):165-9
AD - Section of Laparoscopic and Minimally Invasive Surgery, Urological
Institute, The Cleveland Clinic Foundation, Ohio 44195, USA.
BACKGROUND AND PURPOSE: Retroperitoneoscopy has not been widely
considered the preferred approach to laparoscopic radical nephrectomy
for cancer, in part because the retroperitoneal anatomic landmarks have
not been well defined. The aim of this study is to provide prospective,
objective data on retroperitoneoscopic radical nephrectomy with regard
to anatomic landmarks and time management of the sequential operative
steps. MATERIALS AND METHODS: A uniform database was devised to record
predetermined intraoperative parameters prospectively in 18 consecutive
retroperitoneoscopic radical nephrectomies. RESULTS: A three- or
four-port technique was employed to perform 10 left and 8 right
retroperitoneoscopic radical nephrectomies. Initial balloon dilation was
routinely performed outside of and posterior to Gerota's fascia. The
anatomic landmarks visible immediately on initial insertion of the
laparoscope were: psoas muscle in 18 cases (100%), Gerota's fascia in 18
(100%), peritoneal reflection in 15 (83%), ureter and/or gonadal vein in
11 (61%), and renal artery pulsations in 10 (56%). Aortic pulsations
were seen in 9 of 10 left (90%) and the inferior vena cava in 2 of 8
right (25%) radical nephrectomies. The mean surgical time was 203 +/-
52.9 minutes (range 105-290 minutes). The sequential operative steps and
their individual time breakdowns were: port placement 12 +/- 3.9
minutes, hilar dissection 63 +/- 29.1 minutes, adrenal mobilization 49
+/- 12.1 minutes, specimen mobilization 19 +/- 20.8 minutes, and
specimen entrapment and exit 23 +/- 18.2 minutes. When the initial
balloon dilation resulted in visibility of four or more anatomic
landmarks, the hilar dissection time was significantly shorter (P <
0.001). CONCLUSIONS: Proper development of the retroperitoneal space and
identification of adequate anatomic landmarks is important during
retroperitoneoscopy. This timed analysis of the sequential operative
steps of retroperitoneoscopic radical nephrectomy has served as an
important self-assessment tool for us in improving our surgical
technique. As a result, our surgical time for retroperitoneoscopic
radical nephrectomy has decreased from the earlier 4- to 5-hour range to
the current 2- to 3-hour range.
8
UI - 10886077
AU - Dhote R; Pellicer-Coeuret M; Thiounn N; Debre B; Vidal-Trecan G
TI -
Risk factors for adult renal cell carcinoma: a systematic review and
implications for prevention.
SO - BJU Int 2000 Jul;86(1):20-7
AD - Service de Sante Publique, Service de Medecine Interne, Universite Rene
Descartes, CHU Cochin Port-Royal, Saint-Jacques, Paris, France.
robin.dhote@cch.ap-hop-paris.fr
9
UI - 11890260
AU - Kume H; Takahashi S; Teramoto S; Isurugi K
TI -
Risk factors for adult renal cell carcinoma: a systematic review and
implications for prevention.
SO - BJU Int 2001 Nov;88(7):804
10
UI - 12076276
AU - Oh RR; Park JY; Lee JH; Shin MS; Kim HS; Lee SK; Kim YS; Lee SH; Lee SN;
TI -
Yang YM; Yoo NJ; Lee JY; Park WS
Expression of HGF/SF and Met protein is associated with genetic
alterations of VHL gene in primary renal cell carcinomas.
SO - APMIS 2002 Mar;110(3):229-38
AD - Department of Pathology and Genetic Oncology Laboratory, College of
Medicine, The Catholic University of Korea, Seoul.
We analyzed the genetic alterations of VHL, HGF/SF, and Met genes and
the expression pattern of HGF/SF and Met protein in 26 renal cell
carcinomas (RCCs). We found five mutations of the VHL gene and frequent
LOH (50%) only in non-papillary clear cell RCC. We found six cases in
which the CpG island of VHL was methylated. In addition, one missense
mutation of the HGF/SF gene was detected in clear cell RCC. HGF/SF and
Met protein were expressed in 84.6% and 80.7% of RCCs, respectively. All
of the cases with the genetic alterations of VHL or HGF/SF demonstrated
strong expression of HGF/SF and Met protein in RCC cells. Statistically,
genetic alterations of VHL and HGF/SF were significantly correlated with
HGF/SF and Met expression (Fisher's exact test, p=0.022 and p=0.0070).
Thus, these results strongly suggest that the expression of HGF/SF and
Met protein is closely associated with the genetic alterations of VHL
and HGF/SF in primary RCCs.
11
UI - 12050483
AU - Harada H; Furuya M; Ishikura H; Shindo J; Koyanagi T; Yoshiki T
TI -
Expression of matrix metalloproteinase in the fluids of renal cystic
lesions.
SO - J Urol 2002 Jul;168(1):19-22
AD - Division of Pathophysiological Science, Department of
Pathology/Pathophysiology, Hokkaido University Graduate School of
Medicine, Sapporo, Japan.
PURPOSE: Cystic lesions of the kidney are common conditions usually
diagnosed by imaging. Although simple cysts are easy to diagnose,
preoperative diagnosis of a complicated cystic lesion can be difficult.
There is little information available on the biological activity of
cystic fluid and associations with clinicopathological findings. We
analyzed the expression of matrix metalloproteinase (MMP) in the fluids
of benign and malignant renal cystic lesions to clarify matriolytic
activities in the cyst. MATERIALS AND METHODS: Included in this study
were 22 samples of cystic fluids from renal cystic lesions, including 14
benign cysts and 8 cystic renal cell carcinomas. MMP-2 and 9 was
determined in fluids using gelatin zymography and enzyme-linked
immunosorbent assay. RESULTS: MMP-2 expression was ubiquitously observed
on zymography except for 2 benign cysts associated with acquired cystic
disease of the kidney. MMP-9 was detected in 7 of 8 carcinomas but in
only 2 of 14 benign cysts (p <0.01). The concentration of MMP-2 and 9
was significantly higher in cystic carcinomas than in benign cysts (p
<0.01). CONCLUSIONS: Our data show that MMPs were detectable in cystic
fluids in the presence of renal cystic changes. MMP-2 and 9 are more
abundant in cystic carcinoma fluids than in benign cystic fluids. These
observations suggest that matriolytic enzymes in renal cystic fluid
reflect biological aggressiveness and in part explain the pathogenesis
of renal cystic lesions.
12
UI - 12050480
AU - Yohannes P; Smith AD
TI -
The endourological management of complications associated with horseshoe
kidney.
SO - J Urol 2002 Jul;168(1):5-8
AD - Department of Urology, Albert Einstein College of Medicine, Long Island
Jewish Medical Center Campus, New Hyde Park, New York, USA.
PURPOSE: Horseshoe kidneys are the most common renal fusion anomalies.
Ureteropelvic junction obstruction, urolithiasis and renal malignancies
are the most common complications that occur in this patient population.
Endourological management of these complications has decreased
perioperative morbidity. We identified the applications of minimally
invasive surgery for treating complications secondary to horseshoe
kidney. MATERIALS AND METHODS: A comprehensive literature review of the
different endourological approaches in the management of complications
secondary to horseshoe kidney was performed using MEDLINE. RESULTS:
Ureteropelvic junction obstruction can be managed by percutaneous
endopyelotomy or laparoscopic pyeloplasty with good results. Small
stones associated with horseshoe kidney are best managed by shock wave
lithotripsy, while stones that have failed management by shock wave
lithotripsy or are greater than 2 cm. are best managed percutaneously.
All patients should undergo metabolic evaluation. Ureteroscopy or shock
wave lithotripsy is associated with a higher residual stone rate than
the percutaneous approach. Laparoscopic nephrectomy is a safe and
feasible option for benign and malignant horseshoe kidney diseases.
CONCLUSIONS: Endourological techniques can be safe and effective for
treating complications secondary to horseshoe kidney.
13
UI - 12050491
AU - Sweeney P; El-Naggar AK; Lin SH; Pisters LL
TI -
Biological significance of c-met over expression in papillary renal cell
carcinoma.
SO - J Urol 2002 Jul;168(1):51-5
AD - Department of Urology, University of Texas M. D. Anderson Cancer Center,
Houston, Texas 77030, USA.
PURPOSE: Hereditary papillary renal cell carcinoma is associated with
mutations of the c-met proto-oncogene. Similar aberrations have been
described at a molecular level in up to 13% of sporadic papillary renal
cell carcinomas. We assessed c-met expression in papillary renal cell
carcinomas and evaluated the prognostic significance of c-met expression
in patients with this tumor. MATERIALS AND METHODS: We performed
immunohistochemical testing to identify c-met expression in archival
specimens of 55 papillary renal cell carcinomas in 51 patients. Only 1
patient reported a family history of renal malignancy. RESULTS: We
identified c-met protein expression in the cytoplasm and cell membrane
of 80% and 56% of these tumors, respectively. c-met expression
significantly correlated with higher stage tumors (p = 0.004) but it was
not associated with Fuhrman nuclear grade (p = 0.157). A trend toward a
higher overall survival rate was noted in patients in whom tumors did
not express c-met but this association failed to achieve statistical
significance (p = 0.07). CONCLUSIONS: Our study indicates that c-met
over expression may be associated with an aggressive phenotype in these
tumors.
14
UI - 12050492
AU - Ward JF; Blute ML; Cheville JC; Lohse CM; Weaver AL; Zincke H
TI -
The influence of pNx/pN0 grouping in a multivariate setting for outcome
modeling in patients with clear cell renal cell carcinoma.
SO - J Urol 2002 Jul;168(1):56-60
AD - Department of Urology, and Section of Biostatistics, Mayo Clinic,
Rochester, Minnesota, USA.
PURPOSE: Lymphadenectomy, especially extended lymphadenectomy, is not
commonly performed in patients undergoing a radical nephrectomy for
clear cell renal cell carcinoma. Surgeons may sample suspicious regional
lymph nodes, but the lymph node status of many patients with renal cell
carcinoma remains unknown, termed stage pNx. Outcome models based on
large institutional reviews have been criticized for grouping stages pNx
and pN0 cases because of concern that the pNx category may include
unrecognized stages pN1/pN2 disease. We evaluated cancer specific
survival differences in patients with clear cell renal cell carcinoma
and a lymph node stage of pNx, pN0 or pN1/pN2. MATERIALS AND METHODS: We
searched the registry at our institution for patients who underwent
radical nephrectomy for clear cell histology renal cell carcinoma
between 1970 and 1998. Those with distant metastases at surgery were
excluded from study. Clinical features obtained from the medical record
included age at surgery, history of tobacco use, hypertension and
symptomatic disease at presentation. A single urological pathologist
reviewed all tumor specimens for nuclear grade, tumor necrosis, surgical
margin status, 1997 tumor stage and lymph node status. These features
were compared in patients with stages pNx and pN0 tumors. Cox
proportional hazards models were used to compare cancer specific
survival in univariate fashion, and after adjusting for tumor stage and
grade. RESULTS: The study cohort consisted of 1,535 patients with
sporadic, unilateral clear cell renal cell carcinoma who underwent
radical nephrectomy. There were 600 patients (39%) with stage pNx, 870
(57%) with stage pN0 and 65 (4%) with stages pN1/pN2 tumors. At an
average of 4.2 years after surgery 414 patients died of renal cell
carcinoma. On univariate analysis patients with stage pN0 tumors were
significantly more likely to die of renal cell carcinoma than those with
stage pNx tumors (risk ratio 1.40, 95% confidence interval 1.12 to 1.75,
p = 0.003). However, after adjusting for tumor stage and nuclear grade
the difference in outcome for stages pNx and pN0 tumors was not
statistically significant (risk ratio 1.07 95% confidence interval 0.85
to 1.34, p = 0.583). Patients with stage pNx disease were significantly
less likely to be symptomatic at presentation (p = 0.002), have tumors
that were less than 5 cm. (p <0.001) and of lower stage (p <0.001) and
grade (p = 0.005), and to have tumors with necrosis (p = 0.024) than
patients with stage pN0 disease. CONCLUSIONS: Combining stages pNx and
pN0 cases to create outcome prediction models after radical nephrectomy
for clear cell renal cell carcinoma is appropriate in a multivariate
setting that includes tumor stage and grade. Clinical features available
preoperatively and during surgery can help guide the decision to perform
limited lymph node sampling. When the tumor is 5 cm. or greater, shows
pathological necrosis or is advanced grade 3 or 4, lymph node sampling
adds little prognostic information.
15
UI - 12087966
AU - Campodonico F; Carmignani G; Toncini C
TI -
Bilateral renal oncocytosis with renal failure.
SO - Arch Pathol Lab Med 2002 Jun;126(6):648-9
16
UI - 12019174
AU - Esteban-Barragan MA; Avila P; Alvarez-Tejado M; Gutierrez MD;
TI -
Garcia-Pardo A; Sanchez-Madrid F; Landazuri MO
Role of the von Hippel-Lindau tumor suppressor gene in the formation of
beta1-integrin fibrillar adhesions.
SO - Cancer Res 2002 May 15;62(10):2929-36
AD - Servicio de Inmunologia, Hospital de la Princesa, Universidad Autonoma
de Madrid (UAM), Diego de Leon 62, 28006 Madrid, Spain.
The von Hippel-Lindau tumor suppressor gene (VHL) is absent or
inactivated in the VHLcancer syndrome and in most sporadic renal
cancers. VHL is requiredfor the assembly of a proper extracellular
fibronectin matrix, although the exact mechanism remains unknown. In
this report, we demonstrate that 786-O renal cancer cells are unable to
organize an adequate matrix even in the presence of an excess of
exogenous fibronectin. Because the formation of integrin fibrillar
adhesions plays a pivotal role in the organization of extracellular
fibronectin, we next examined the expression and subcellular
distribution of integrins in VHL- cells and their wild-type VHL stably
transfected counterparts. The levels of beta1 and alphav integrins were
increased in VHL- cells when compared with VHL+ transfectants. Early
after plating, both VHL+ and VHL- cells were capable of assembling
classic "patch-like" alphav focal contacts. As the culture advanced and
cells became confluent, alphav integrins partly relocated to the
intercellular junctions in VHL+ transfectants, which then developed
large beta1 fibrillar-type adhesions and anchored firmly to the
substrate. In contrast, confluent VHL- cells were unable to assemble
beta1 fibrillar adhesions, and alphav focal contacts remained unchanged
at all stages of the culture. Exogenous activation of beta1 integrins
with either divalent cations or activating antibodies partly restored
the capability of VHL- cells to assemble beta1 fibrillar adhesions and
fibronectin fibers. Finally, pulse-chase studies of metabolically
labeled 786-O cells revealed that the maturation of the common
beta1-integrin chain was delayed in VHL- cells when compared with VHL+
cells. Our results show that VHL is an important regulator of integrins
and is essential for the formation of beta1 fibrillar adhesions. These
findings help to explain the abnormal extracellular matrix organization
and increased motility of VHL- renal cancer cells.
17
UI - 12019178
AU - Turner KJ; Moore JW; Jones A; Taylor CF; Cuthbert-Heavens D; Han C; Leek
TI -
RD; Gatter KC; Maxwell PH; Ratcliffe PJ; Cranston D; Harris AL
Expression of hypoxia-inducible factors in human renal cancer:
relationship to angiogenesis and to the von Hippel-Lindau gene mutation.
SO - Cancer Res 2002 May 15;62(10):2957-61
AD - Imperial Cancer Research Fund Molecular Oncology Laboratory and
Angiogenesis Group, Institute of Molecular Medicine, John Radcliffe
Hospital, Oxford OX3 9DU, UK.
The von Hippel-Lindau tumor suppressor protein acts as the substrate
recognition component of a ubiquitin E3 ligase that targets
hypoxia-inducible factor (HIF)-alpha subunits for proteolysis.
Stabilization of HIF-alpha subunits has been described in VHL-defective
cell lines, leading to HIF activation and up-regulation of
hypoxia-inducible mRNAs. Mutations of the von Hippel-Lindau tumor
suppressor protein are found in most clear cell renal cell carcinomas
(CC-RCCs) but not other renal tumors, raising a question about the
importance of activation of the HIF pathway in CC-RCC development. To
address this question, we have examined the expression of HIF-alpha
subunits in 45 primary renal tumors and related this to tumor subtype,
the presence of VHL mutations, and measures of angiogenesis. We show
that HIF-alpha is up-regulated in the majority of CC-RCCs, and that the
pattern of expression is biased toward the HIF-2alpha isoform.
Expression of HIF-alpha proteins was associated significantly with
up-regulation of VEGF mRNA and protein and increased microvessel
density. Up-regulation of HIF-alpha in CC-RCC was found to involve
increased mRNA as well as protein expression, suggesting that both
VHL-dependent and VHL-independent mechanisms are involved. These results
suggest that activation of the HIF pathway is functionally important in
CC-RCC development and might provide a new therapeutic target.
18
UI - 12049011
AU - Csekeo A; Fawzi Sel-T
TI -
[Surgical treatment for metastatic renal cell tumors of the lung]
SO - Magy Seb 2002 Apr;55(2):73-6
AD - Orszagos Koranyi Tbc es Pulmonologiai Intezet Mellkassebeszeti Osztaly,
1529 Budapest. csekeo@koranyi.hu
Number of resection for lung metastasis in Hungary is low, however
surgery provides benefit for patients using an integrated oncological
therapeutical protocol. The authors give a retrospective analysis of 57
patients operated on for metastatic renal cell tumor to the lung.
Metastases were discovered most frequently by x-ray picture of an
accidental investigation or screening at symptom-free patients and in 32
cases solitary and in 25 cases multiple deposits were proved. After
selection's protocol 20 patients underwent lobectomy and 32 ones wedge
resection while in 5 cases only biopsy was done. Out of 52 cases 33
complete resections were performed and in 9 cases incomplete resection
was carried out. The cumulative five-year survival time was 35%,
following complete resection 45%. If DFI was longer than 12 months,
survival was observed 38% at five year. SUMMARY: On basis of our
experience after surgery of metastatic renal cell tumors to the lung
might expect favourable survival which is significantly better after
complete resection of lung metastasis and after longer than 12 months
DFI.
19
UI - 12070267
AU - Shenouda A; Douglas SA; Ohlstein EH; Giaid A
TI -
Localization of urotensin-II immunoreactivity in normal human kidneys
and renal carcinoma.
SO - J Histochem Cytochem 2002 Jul;50(7):885-9
AD - The Montreal General Hospital, McGill University, Montreal, Quebec,
Canada.
Human urotensin-II (U-II) is a cyclic 11-amino-acid residue peptide with
a wide range of vasoactive properties dependent on the anatomic site and
the species studied. The purpose of this study was to determine the
localization of human U-II in normal human kidneys and in renal
carcinoma. Normal human kidneys (n=11) and eight cases of clear-cell
carcinoma were immunostained with a polyclonal antibody to human U-II.
In normal human kidneys, U-II was mostly present in the epithelial cells
of tubules and ducts, with greater intensity in the distal convoluted
tubules. Moderate U-II immunoreactivity was seen in the endothelial
cells of renal capillaries, but only focal immunoreactivity was found in
the endothelial cells of the glomeruli. No staining was found in the
veins. All tumors expressed moderate U-II immunoreactivity in the cancer
cells and vasculature. Here we demonstrate abundant expression of U-II
in normal human kidneys and renal carcinoma. These findings suggest that
the vasoactive and growth-mediator peptide U-II may contribute to the
pathophysiology of the human renal system.
20
UI - 12109446
AU - Akaza H; Miyanaga N
TI -
[Guideline for proper use of antineoplastic agents. Urologic cancer]
SO - Gan To Kagaku Ryoho 2002 Jun;29(6):1055-64
21
UI - 11337362
AU - Young AN; Amin MB; Moreno CS; Lim SD; Cohen C; Petros JA; Marshall FF;
TI -
Neish AS
Expression profiling of renal epithelial neoplasms: a method for tumor
classification and discovery of diagnostic molecular markers.
SO - Am J Pathol 2001 May;158(5):1639-51
AD - Department of Pathology, Emory University School of Medicine, Atlanta,
USA.
The expression patterns of 7075 genes were analyzed in four conventional
(clear cell) renal cell carcinomas (RCC), one chromophobe RCC, and two
oncocytomas using cDNA microarrays. Expression profiles were compared
among tumors using various clustering algorithms, thereby separating the
tumors into two categories consistent with corresponding
histopathological diagnoses. Specifically, conventional RCCs were
distinguished from chromophobe RCC/oncocytomas based on large-scale gene
expression patterns. Chromophobe RCC/oncocytomas displayed similar
expression profiles, including genes involved with oxidative
phosphorylation and genes expressed normally by distal nephron,
consistent with the mitochondrion-rich morphology of these tumors and
the theory that both lesions are related histogenetically to distal
nephron epithelium. Conventional RCCs underexpressed mitochondrial and
distal nephron genes, and were further distinguished from chromophobe
RCC/oncocytomas by overexpression of vimentin and class II major
histocompatibility complex-related molecules. Novel, tumor-specific
expression of four genes-vimentin, class II major histocompatibility
complex-associated invariant chain (CD74), parvalbumin, and
galectin-3-was confirmed in an independent tumor series by
immunohistochemistry. Vimentin was a sensitive, specific marker for
conventional RCCs, and parvalbumin was detected primarily in chromophobe
RCC/oncocytomas. In conclusion, histopathological subtypes of renal
epithelial neoplasia were characterized by distinct patterns of gene
expression. Expression patterns were useful for identifying novel
molecular markers with potential diagnostic utility.
22
UI - 11702121
AU - Helenon O; Correas JM; Balleyguier C; Ghouadni M; Cornud F
TI -
Ultrasound of renal tumors.
SO - Eur Radiol 2001;11(10):1890-901
AD - Department of Radiology, Necker Hospital, 149 rue de Sevres, 75743
Paris, France. olivier.helenon@nck.ap-hop-paris.fr
Despite the limitations of US in providing a complete evaluation of
renal tumors before treatment planning, initial screening,
characterization of renal masses and staging of RCCs can benefit from
some recent advances of the technique. One of the most relevant clinical
benefits of US is the increased early detection of RCCs. Recent
technical improvement of gray-scale imaging has increased US performance
in the detection of small renal tumors. Combined gray-scale and color
Doppler US findings may strongly suggest the histopathologic nature of a
renal tumor with respect to the size, the US attenuation
characteristics, and the vascular distribution of the lesion. Ultrasound
contributes additional diagnostic information for differential diagnosis
of some renal masses that remain equivocal at CT, including: atypical
cystic lesions; solid renal tumors with poor vascularity; and
angiomyolipomas with minimal fat component. Ultrasound also may provide
additional diagnostic information over CT in selected cases of RCCs with
venous invasion. In addition to some diagnostic and therapeutic
procedures that can benefit from US guidance, intraoperative US remains
the only available tool that enables to ensure renal-parenchymal-sparing
surgery.
23
UI - 11702145
AU - Walter C; Heindel W; Kruessell M; Kugel H; Jung G; Gindele A
TI -
Fast sequences with fat suppression in breath-hold mode: new standard in
contrast-enhanced T1-weighted MR imaging of renal tumors?
SO - Eur Radiol 2001;11(10):2092-8
AD - Department of Diagnostic Radiology, University of Cologne, 50924 Koln,
Germany. walter@fh-trier.de
Our purpose was to analyze detection, diagnostic characterization, and
staging of renal solid lesions using different fast T1-weighted
sequences with fat suppression in breath-hold mode compared with a
gradient-echo sequence after contrast application. Twenty-five patients
with focal renal lesions were examined with a T1-weighted ultrafast
turbo spin-echo (UTSE) sequence with frequency selective fat suppression
(SPIR), two different segmented echo-planar imaging (EPI) sequences - a
spin-echo and a gradient-echo echo-planar sequence (SE-, FFE-EPI)
combined with SPIR and a gradient-echo (fast field echo, FFE) sequence
in a prospective study. The images of all sequences were visually
evaluated and in addition to qualitative evaluation the
contrast-to-noise ratio (CNR) for cyst and solid lesions was measured.
Among the different T1-weighted sequences, the best detection and
characterization of renal solid lesions were obtained with the UTSE SPIR
and the SE-EPI sequence (sensitivity: 100 and 75%, respectively;
specificity: 90 and 75%, respectively). The FFE and FFE-EPI sequences
showed lower sensitivity (86%) and the same specificity (75%). The
staging of renal tumors was best achieved with the UTSE SPIR and SE-EPI
sequence (84 and 73%, respectively). The staging was correct in only 47%
and 58 for the FFE and FFE-EPI sequences, respectively. The investigated
sequences showed no significant differences in CNR. The combination of
fat suppression and breath-hold mode improves detection,
characterization, and staging of renal lesions. The UTSE SPIR and SE-EPI
sequence in breath-hold mode showed specific image artifacts, but
offered high sensitivity and specificity for detection and
characterization of renal lesions compared with the FFE sequence. The
results of this study suggest, for T1-weighted imaging of renal tumors,
use of UTSE or SE-EPI sequences with fat suppression in breath-hold mode
for renal imaging.
24
UI - 11684839
AU - Mickisch G; Carballido J; Hellsten S; Schulze H; Mensink H; European
TI -
Association of Urology
Guidelines on renal cell cancer.
SO - Eur Urol 2001 Sep;40(3):252-5
AD - Erasmus University Rotterdam, The Netherlands. mickisch@urol.azr.nl
OBJECTIVES: On behalf of the European Association of Urology (EAU),
Guidelines for Diagnosis, Therapy and Follow-Up of Renal Cell Carcinoma
Patients were established. Criteria for recommendations were evidence
based and included aspects of cost-effectiveness and clinical
feasibility. METHOD: A systematic literature research using Medline
Services was conducted. References were weighted by a panel of experts
on renal cell carcinoma (RCC). RESULTS: RCC is characterised by a
constant rise in incidence over the last 50 years, with a predominance
of men over women and an incidence peak in the 6th and 7th decade. There
is no risk factor established and the current TNM system (UICC, 1997) is
endorsed for staging purposes. Clinical signs and symptoms of RCC are
becoming less frequent, incidental discovery constitutes already a
majority of cases. Diagnosis is established by ultrasound and abdominal
CT, extension assessment in routine cases is done by chest X-ray.
Additional examinations may be required in select cases. The therapy of
choice in organ-confined RCC is surgery. Radical tumour nephrectomy is
considered as a standard. Efficacy and side-effects of organ-sparing
surgery, lymphadenectomy and inclusion/omission of ipsilateral
adrenalectomy in selected cases is a matter of ongoing clinical
research. In metastatic cases, tumour nephrectomy should only be
considered in the context of modern systemic immunotherapy. A follow-up
at regular intervals is recommended because certain cases of recurrences
may be candidates for surgery and/or immunomodulating therapy.
CONCLUSION: A rise in incidence, improved diagnostic procedures, and
evolving multimodality therapeutic concepts justify the need for
rational guidelines on this most challenging urologic malignancy.
25
UI - 11684849
AU - Huguet-Perez J; Palou J; Millan-Rodriguez F; Salvador-Bayarri J;
TI -
Villavicencio-Mavrich H; Vicente-Rodriguez J
Upper tract transitional cell carcinoma following cystectomy for bladder
cancer.
SO - Eur Urol 2001 Sep;40(3):318-23
AD - Department of Urology, Fundacio Puigvert, Barcelona, Spain.
PURPOSE: We assessed the incidence of upper urinary tract tumors (UUTTs)
after cystectomy for invasive or superficial transitional cell carcinoma
(TCC) of the bladder. The risk factors, patients' characteristics and
evolution of those who developed UUTTs are analyzed. MATERIALS AND
were performed for TCC of the bladder: in 469 instances (82.5%) due to
invasive tumor (T2-T4), and in 99 cases (17.5%) for superficial tumor
(Ta, T1, Tis). All patients were followed for at least 5 years or until
death. A retrospective study of patients who developed UUTTs has been
performed. A revision of bladder tumor and UUTT characteristics, and the
intervals between both is also evaluated. RESULTS: 26 patients (4.5%)
developed UUTTs: 11 of the 99 patients cystectomized for superficial
TCCs (11.1%); 6 of the 392 patients with primary invasive TCC (1.5%),
and 9 of the 77 (11.6%) patients with invasive tumors and a prior
history of superficial TCC. The interval to the development of UUTT was
higher after cystectomy for superficial tumor. TCCs of the bladder that
subsequently developed UUTTs were high grade in 84%, multifocal in 80%,
or had carcinoma in situ in 65%, tumor in the prostatic urethra in 52%,
and involvement of the distal ureter in 57%. Twenty-two UUTTs (84%) were
located in the calyces or the renal pelvis, 3 were bilateral (11.5%), 14
multiple (58%) and 4 superficial (16%). With a median follow-up time of
18 (range 3-103) months, 14 patients (53.8%) died of tumor, 2 were alive
with disease, 2 were lost for follow-up, and 8 (30%) were alive and free
of disease. CONCLUSIONS: We found that patients cystectomized for
superficial or invasive TCC with a prior history of superficial TCC have
a higher incidence of UUTTs. These cases require follow-up with annual
urography or loopography.
26
UI - 11684851
AU - Junker K; Weirich G; Moravek P; Podhola M; Ilse B; Hartmann A; Schubert
TI -
J
Familial and sporadic renal oncocytomas--a comparative molecular-genetic
analysis.
SO - Eur Urol 2001 Sep;40(3):330-6
AD - Department of Urology, Jena, Germany. kerstin.junker@med.uni-jena.de
OBJECTIVES: Genetic causes of sporadic and familial renal oncocytomas
are not known. We analyzed these tumors genetically in order to detect
tumor-specific chromosome alterations. METHODS: DNA from 26 sporadic and
31 familial renal oncocytomas were screened by comparative genomic
hybridization according to standard protocols including degenerate
oligonucleotide-primed PCR. RESULTS: Chromosome alterations were
detected in 19/26 sporadic (73%) and in 4/31 familial renal oncocytomas
(13%). Partial or complete losses of chromosome 1 were most frequently
found in both sporadic (15/26) and familial tumors (2/4). Less
frequently, loss of chromosome 14 (3/26) was detected in sporadic renal
oncocytomas as well as losses of 2p, 2q, 4q, 10 and 18 and gains of 1q
and 17q in individual sporadic tumors. Inter-tumor variation of
chromosome aberrations was prominent in 1 patient, where 1 tumor showed
gains of chromosomes 5, 6q, 7, 10p, 12 and 13q, whereas the second tumor
exhibited gains of chromosomes 5 and 7 and loss of 10q. In contrast to
sporadic renal oncocytomas, most familial tumors (87%) were devoid of
chromosome instabilities. CONCLUSION: Our results demonstrate that
partial or complete loss of chromosome 1 is the most common alteration
in renal oncocytomas, sporadic and familial. However, chromosome changes
are much rarer in familial than in sporadic renal oncocytomas.
27
UI - 11684852
AU - Spahn M; Portillo FJ; Michel MS; Siegsmund M; Gaa J; Alken P; Junemann
TI -
KP
Color Duplex sonography vs. computed tomography: accuracy in the
preoperative evaluation of renal cell carcinoma.
SO - Eur Urol 2001 Sep;40(3):337-42
AD - Department of Urology, Klinikum Mannheim GmbH, University of Heidelberg,
Mannheim, Germany.
PURPOSE: Accurate imaging is essential for correct operative planning
and successful surgical intervention in renal cell carcinoma (RCC). Our
objective was the comparison of color duplex sonography with spiral
computed tomography (CT) and surgical-pathological findings in the
evaluation of renal masses to determine tumor localization, size, tumor
thrombus extent and lymph node metastases. METHODS: We evaluated 60
patients with a renal mass in a prospective study. Both color duplex
sonography and CT were performed by different investigators without
knowledge of the supposed diagnosis. The color Doppler findings were
compared to CT and surgical pathological findings. RESULTS: The
sensitivity of color duplex sonography in the detection of RCC and lymph
node metastases is comparable to that of CT (100%). Color duplex
sonography was superior in the detection of renal vein involvement.
Color duplex sonography alone allowed correct planning of the surgical
procedure without intraoperative changes in all patients. CONCLUSION:
Duplex sonography provides exactly the same information as CT. Although
duplex sonography is less expensive with lower exposure to radiation,
most surgeons will still probably demand CT for diagnosis, especially as
this method is unerring and duplex sonography highly depends on the
expertise of the person using it.
28
UI - 12036906
AU - Bindra RS; Vasselli JR; Stearman R; Linehan WM; Klausner RD
TI -
VHL-mediated hypoxia regulation of cyclin D1 in renal carcinoma cells.
SO - Cancer Res 2002 Jun 1;62(11):3014-9
AD - Cell Biology and Metabolism Branch, National Institute of Child Health
and Human Development, NIH, Bethesda, MD 20892, USA.
Renal cell carcinoma is associated with mutation of the von
Hippel-Lindau (VHL) tumor suppressor gene. Cell lines derived from these
tumors cannot exit the cell
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