National Cancer Institute®
Last Modified: September 1, 2002
UI - 12175550
AU - Kaufmann R; Junker U; Junker K; Nuske K; Ranke C; Zieger M; Scheele J
TI - The serine proteinase thrombin promotes migration of human renal carcinoma cells by a PKA-dependent mechanism.
SO - Cancer Lett 2002 Jun 28;180(2):183-90
AD - Department of General and Visceral Surgery, Medical Faculty at the Friedrich Schiller University Jena, Bachstr. 18, 07740 Jena, Germany. firstname.lastname@example.org
In this study, we demonstrated that thrombin activates protein kinase C (PKC), mitogen activated protein kinases (MAP kinases), transcription factor nuclear factor-kappa B (NF-kappa B), and cAMP-dependent protein kinase (PKA) in the human renal carcinoma cell line A-498. In addition, it enhanced the migratory capacity, but had no effect on the proliferation of A-498 cells. The effect of thrombin on migration could be blocked by the PKA inhibitor H-89 but was not influenced by inhibition of PKC, MAP kinases or NF-kappa B. We concluded, that thrombin acts as a regulator on human A-498 renal carcinoma cell migration including PKA.
UI - 11753249
AU - Cindolo L; Cantile M; Galasso R; Marsicano M; Napodano G; Altieri V
TI - Not traditional prognostic factors in human conventional renal carcinoma.
SO - Minerva Urol Nefrol 2001 Dec;53(4):211-9
AD - Clinica Urologica, Universita degli Studi di Napoli Federico II, Naples, Italy. email@example.com
The evaluation of know prognostic factors is an essential step of the assessment of the patients affected by primary renal carcinoma. As long as the major biological mechanisms of renal carcinomas remain unknown, it will be impossible to achieve an accurate prognostic judgement. The TNM classification has always been the main source of information. Nevertheless, recently several investigations evaluated the prognostic power of serum and cellular markers. The aim of this study is to identify those markers which show statistical reliability and can be used in the clinical practice. A literature search was performed on MEDLINE to identify potential not traditional prognostic factors for keywords. We considered also articles cited in references of first selected manuscript. The analysis of serum and cellular prognostic markers does not allow the identification of specific factors, reliable, independent, easy to dose, widely useful and whose informations are repeatable. Currently classical prognostic factors (staging, grading, hystologic type, patient clinical conditions, anaemia, presentation modalities, etc.) represent the only useful elements after surgical time in RCC patients. Among serum prognostic factors, CRP and ferritin play a crucial role. These proteins appear ideal in monitoring the disease over time, due to simple test execution and specimens repeatability. Among RCC molecular markers, proliferation index result promising for their reliability and reproducibility, the easy dosage and high series number tested. Literature data suggest that the ideal marker for renal carcinomas has not been identified yet. However, C-reactive protein, ferritin and the proliferative activity indexes (Ki67 and AgNOR) appear to be, at present, the best prognostic tools. To confirm obtained results and to use biomolecolar markers on a routinary base further studies on wide surgical series will be required. The improvement of technical tool and costs reduction represent also a necessary step toward the identification of efficient prognostic markers in RCC.
UI - 11852517
AU - Navas Pastor J; Garcia Ligero J; Garcia Garcia F; Tomas Ros M; Rico
TI - Galiano JL; Sempere Gutierrez A; Gil Franco J; Fontana Compiano LO [Synchronous tumor of the upper urinary tract with bladder cancer. Opportunity for nephroureterectomy and block-cystectomy]
SO - Arch Esp Urol 2001 Dec;54(10):1095-102
AD - Servicio de Urologia, Hospital General Universitario, Murcia, Espana.
OBJECTIVE: One of the basic characteristics of urothelial carcinoma is its tendency to synchronous or metachronous multifocality. Thus the need to explore the entire urinary tract of patients with urothelial neoformations. The aim of this article is to study the tumors of the upper urinary tract that appear synchronously with infiltrating carcinoma of the bladder. The clinicopathological characteristics and the morbidity and mortality of en bloc surgery of both tumors are analyzed. METHODS: A retrospective study was carried out on 170 radical cystectomies for infiltrating bladder tumor performed in our department over a 13-year period. Patient history, clinicopathological characteristics, complementary tests, type of surgery performed, postoperative complications and follow-up were analyzed. RESULTS: Tumor of the upper urinary tract appeared in 14 (1 bilateral) of these patients and were synchronous in 10 cases. All patients were male; mean age 63 years. Three were localized in the pelvis, 2 in the proximal ureter and 6 in the distal third. Diagnosis was made by IVP in 6 patients and by US and antegrade pyelography in the other 4 patients. Nephroureterectomy and radical cystectomy were performed en bloc in 8 cases; 6 had a Bricker procedure and 2 ileal substitution. Salvage radical cystectomy + distal ureterectomy were performed in the other two patients. Two patients submitted to en bloc surgery had postoperative complications; one presented prolonged ileua and the other required surgery for retroperitoneal hemorrhage. The two patients submitted to palliative surgery died of and sepsis during the postoperative period. At 33 months' mean follow-up, 3 patients have shown tumor progression. CONCLUSIONS: There is a high proportion of synchronous tumor of the upper urinary tract in our series of patients with infiltrating carcinoma of the bladder undergoing radical cystectomy, therefore we consider it necessary to explore the entire urinary system. Surgical removal of both tumors en bloc does not increase the morbidity and mortality.
UI - 11859657
AU - Djokic M; Hadzi-Djokic J; Nikolic J; Dragicevic D; Durutovic O;
TI - Radivojevic D [Tumors of the upper urinary tract: results of conservative surgery]
SO - Prog Urol 2001 Dec;11(6):1231-8
AD - Centre clinique de la Serbie, Institut d'Urologie et de Nephrologie, Belgrade, Yougoslavie. m2909d@EUnet.yu
OBJECTIVE: To determine the results of conservative surgery for upper urinary tract urothelial tumours. PATIENTS AND METHODS: From 1986 to 1997, 352 patients were treated in the Belgrade urology clinic for upper urinary tract urothelial tumour. 54 patients (15.3%) were treated by conservative surgery. The sex ratio was 1.3 men for 1 woman. The mean age was 63 years. In most cases, the tumour was situated in the ureter. Conservative surgery was performed on principle in 60% of patients for a small isolated lesion (solitary low-stage, low-grade tumour). In contrast, in about 40% of cases, conservative surgery was performed by necessity due to the presence of bilateral tumours, a solitary kidney or renal failure related to Balkan nephropathy. The median follow-up was 67.3 months (range: 6 months-14 years). RESULTS: 15.8% of patients developed a local recurrence during the follow-up period. The risk of recurrence was higher when conservative surgery was performed for indications of necessity than when it was performed on principle (21.7% versus 11.8%), but the difference was not statistically significant (c2 test, t test). The stage and grade of differentiation were identified as the most significant predictive factors for the risk of local recurrence. The overall 5-year survival rate was 67% with more favourable results in the case of conservative surgery performed on principle compared conservative surgery by necessity (72% versus 60%). The difference between these results was not statistically significant, but a statistically significant difference was observed for tumour stage and grade (grade III versus grade I and II, pT3 versus pT1, pT2). The 5-year survival probability was 68.5%. Recurrence was most likely to occur during the early postoperative course, as 81.56% occurred during the first 18 months. CONCLUSION: Urothelial tumours can be managed conservatively. However, the risk of recurrence is directly correlated with the tumour stage and grade, with a high level of statistical significance, and with the type of indication for conservative surgery performed, but with no statistically significant difference.
UI - 12010365
AU - Leroy X; Copin MC; Devisme L; Buisine MP; Aubert JP; Gosselin B; Porchet
TI - N Expression of human mucin genes in normal kidney and renal cell carcinoma.
SO - Histopathology 2002 May;40(5):450-7
AD - Department of Pathology, University Hospital and Unity INSERM U 377, Lille, France. firstname.lastname@example.org
AIMS: Human mucins are large O-glycoproteins expressed by epithelial cells. Mucins are thought to be implicated in cell protection, cell adhesion and signalling. The aim of this study was to investigate the expression of the human mucin genes (MUC1-4, 5AC, 5B, 6-7) in normal kidney and renal cell carcinoma. METHODS AND RESULTS: We analysed by in-situ hybridization, immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) the expression of these genes in normal adult kidney (n=14) and renal cell carcinomas (n=29). MUC1, MUC3 and MUC6 were expressed both in normal kidney and in renal carcinomas. In normal kidney, MUC1 was expressed in the distal convoluted tubules and in collecting ducts, whereas MUC3 was restricted to the proximal tubules. MUC4 was strongly expressed in epithelial urothelial cells of pyelocalyceal cavities. MUC6 was only detected by RT-PCR. In renal carcinoma, we showed a heterogeneous expression of MUC1 and MUC3 with an over-expression of MUC3 in renal clear cell carcinoma. The level of MUC3 expression by in-situ hybridization was associated with the nuclear grade in clear cell carcinoma. CONCLUSIONS: This study is the first large series investigating human mucin gene expression in the kidney. MUC1, MUC3 and MUC6 are expressed in normal and tumour kidney. The over-expression of MUC3 in renal cell carcinomas favours its implication in renal tumorigenesis.
UI - 12010366
AU - Johnson SR; Clelland CA; Ronan J; Tattersfield AE; Knox AJ
TI - The TSC-2 product tuberin is expressed in lymphangioleiomyomatosis and angiomyolipoma.
SO - Histopathology 2002 May;40(5):458-63
AD - Division of Therapeutics, University of Nottingham, UK. email@example.com
AIMS: Lymphangioleiomyomatosis is categorized by proliferation of abnormal smooth muscle cells (LAM cells) in the lungs and lymphatics and the presence of angiomyolipomas. Recently mutations in the tuberous sclerosis complex-2 gene (TSC-2) have been described in LAM cells and angiomyolipomas. The TSC-2 protein tuberin is a tumour suppressor and its loss may result in cellular proliferation. We used immunohistochemistry to test the hypothesis that uncontrolled cellular proliferation in lymphangioleiomyomatosis is the result of reduced tuberin protein expression. METHODS AND RESULTS: Tissue from normal lung, normal kidney, lymphangioleiomyomatosis and angiomyolipomas was immunostained with three separate anti-tuberin antibodies. Tuberin staining in normal tissues was similar to that previously described. Surprisingly, tuberin was strongly expressed in the LAM cells of all cases of lymphangioleiomyomatosis and angiomyolipoma at a greater level than in normal smooth muscle cells. The perivascular cells of angiomyolipomas, however, did not stain for tuberin. CONCLUSIONS: Our results suggest that a loss of tuberin protein in LAM cells is not the cause of the cellular proliferation seen in lymphangioleiomyomatosis. Lymphangioleiomyomatosis may result either from the expression of a mutant tuberin with abnormal function, as a result of mutations in functionally related proteins, or from more than one mechanism.
UI - 12073046
AU - Primdahl H; von der Maase H; Sorensen FB; Wolf H; Orntoft TF
TI - Immunohistochemical study of the expression of cell cycle regulating proteins at different stages of bladder cancer.
SO - J Cancer Res Clin Oncol 2002 Jun;128(6):295-301
AD - Department of Clinical Biochemistry, Aarhus University Hospital at Skejby, Aarhus N, Denmark.
PURPOSE: The cell cycle is known to be deregulated in cancer. We therefore analyzed the expression of the cell cycle related proteins p21, p27, p16, Rb, and L-myc by immunohistochemical staining of bladder tumors. METHODS: The tissue material consisted of bladder tumors from three groups of patients; group 1, 23 patients with recurrent stage Ta (non-invasive) tumors; group 2, 22 patients presenting at their first admission with T2-4 (muscle invasive) tumors; group 3, 24 patients who experienced disease progression from Ta or T1 (invasive in connective tissue) to a higher stage. By immunohistochemical staining the protein expression was compared to allelic deletions of the corresponding genes. The allelic deletions were detected by PCR-based microsatellite analyses. RESULTS: We detected a significant reduction in the expression levels of the cell cycle related proteins p21(waf1) ( P=0.002), p27(kip1) ( P=0.03), Rb ( P=0.00002), and L-myc ( P=0.00000007) in muscle invasive tumors compared to noninvasive tumors. Tumors presenting as muscle invasive at first diagnosis had significantly lower levels of p16/CDKN2A ( P=0.01) when compared to muscle invasive tumors that followed Ta or T1 precursor lesions. We found no general correlation between allelic deletion of a gene and its immunohistochemical protein expression, indicating that the remaining allele may be capable of encoding a normal or even increased protein level. CONCLUSIONS: Our results support the hypothesis that bladder tumors with invasion at first diagnosis differ from those in which invasion follow superficial tumors. This difference is reflected as a different level in cell cycle related protein expression. The data also indicate that allelic deletions of cell cycle related genes do not correlate with an altered level of protein expression.
UI - 11876546
AU - Kallio JP; Tammela TL; Marttinen AT; Kellokumpu-Lehtinen PL
TI - Soluble immunological parameters and early prognosis of renal cell cancer patients.
SO - J Exp Clin Cancer Res 2001 Dec;20(4):523-8
AD - Division of Urology, Tampere University Hospital, University of Tampere, Finland.
In local or metastatic cancer, a prognostic tumour marker could be a valuable tool in the selection of different treatments. In renal cell cancer (RCC) no such markers have been available. We therefore evaluated the association between several pretreatment serum markers, tumour classification and short term survival in RCC patients. Serum samples were collected before surgery and three months thereafter from 24 RCC patients. Interleukin-6 (IL-6), IL- 12, soluble IL-2 receptor (sIL-2R) and intercellular adhesion molecule-1 (sICAM-1) were measured in serum samples using specific commercial enzyme immunoassay kits. Serum IL-6, sIL-2R and sICAM-1 levels before nephrectomy were significantly higher in non-local tumours than in local ones (mean IL-6 53 pg/ml versus 6.3 pg/ml, and sICAM-1 443 ng/ml versus 290 ng/ml, sIL-2R 3779 pg/ml versus 1796 pg/ml). In contrast, IL-12 levels were higher in local tumours (148 versus 102 pg/ml) and the levels increased significantly (P < 0.005) after removal of the primary tumour in patients with local disease. All patients with local tumours had normal IL-6 values, while only one with a non-local tumour had IL-6 levels below 10 pg/ml. In addition, IL-6 and sICAM-1 levels before operation were significantly higher in patients with short (less than one year) survival (p=0.007 to IL-6 and p=0.006 to sICAM-1). In contrast, patients with shorter survival had significantly lower IL-12 (p=0.03) levels. Our findings suggest that RCC induces changes in several immunological parameters. These soluble immunological factors, IL-6, IL-12, sIL-2R and sICAM-1, might have a role as prognostic factors in RCC.
UI - 11837802
AU - Safaei A; Figlin R; Hoh CK; Silverman DH; Seltzer M; Phelps ME; Czernin
TI - J The usefulness of F-18 deoxyglucose whole-body positron emission tomography (PET) for re-staging of renal cell cancer.
SO - Clin Nephrol 2002 Jan;57(1):56-62
AD - Ahmanson Biological Imaging Clinic/Nuclear Medicine, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA 90095-6948, USA.
PURPOSE: The use of whole-body PET for re-staging of renal cell carcinoma has not been investigated. The aim of the current study was to examine the diagnostic accuracy and clinical usefulness of whole-body PET imaging for re-staging of renal cell cancer. PATIENTS AND METHODS: Clinical PET was performed for re-staging in 36 patients with advanced renal cell cancer. Written reports of imaging studies (including CT, MRI, US, plain film and bone scan), patient history, and extensive chart notes were used to define the clinical stage before PET (pre-PET stage). The written PET report was used to define the clinical stage after PET (PET stage). Reports were used to determine the accuracy of PET for re-staging renal cell cancer and for defining biopsy proven lesions. Clinical parameters and biopsy proven lesions served as reference for the accuracy of PET for re-staging renal cell cancer. RESULTS: PET classified the clinical stage correctly in 32/36 patients (89%) and was incorrect in 4/36 (11%) (sensitivity and specificity: 87% and 100%). In 20 patients, 25 suspicious lesions were biopsied within 3.2 +/- 6.7 months of the PET study. Of these, 17 were malignant and 8 were benign. PET correctly classified 21/25 (84%) of the biopsied lesions (sensitivity and specificity: 88% and 75%). CONCLUSION: PET re-stages renal cell cancer with a diagnostic accuracy of 89%. Its diagnostic accuracy for classifying biopsy proven anatomic lesions as malignant or benign was 84%. These findings suggest that PET is useful in characterizing anatomic lesions of unknown significance in patients with renal cell cancer.
UI - 12068634
AU - Cheburkin IuV; Kniazeva TG; Peter S; Kniazev IuP; Karelin MI; Shkol'nik
TI - MI; Evtushenko VI; Hanson KP; Ullrich A; Kniazev PG [Molecular portrait of human kidney carcinomas: the gene expression profiling of protein-tyrosine kinases and tyrosine phosphatases which controlled regulatory signals in the cells]
SO - Mol Biol (Mosk) 2002 May-Jun;36(3):480-90
AD - Research Institute of Roentgenology and Radiology, Ministry of Health of the Russian Federation, St. Petersburg, 197758 Russia.
Hybridization with cDNA arrays was used to obtain expression profiles of 214 protein-tyrosine kinase, protein-tyrosine phosphatase, dual-specific phosphatase, and other genes for kidney carcinomas (KC) and normal kidney tissues of 34 patients and for seven carcinoma cell lines. Computer analysis revealed three clusters of genes coexpressed in KC. A proliferating-cell gene cluster included MET, VIM, MYC, TOP2A, PCNA, etc. A neoangiogenesis and blood-cell gene cluster included LCK, HCK, FGR, MMP9, CSFR1, VEGF, FLT1, and KDR. A cluster corresponding to normal, differentiated kidney cells included ERBB2 (HER2) for receptor protein-tyrosine kinase, several phosphatase genes (PTPRE, PTPRB, DUSP9), and EGF. The results suggested that MET, DUSP9, PCNA, TOP2A, and VIM may serve as diagnostic and prognostic markers in KC. Tubulin and topoisomerase II were assumed to be promising targets for cell proliferation inhibitors in KC.
UI - 12074796
AU - Murota T; Kawakita M; Oguchi N; Shimada O; Danno S; Fujita I; Matsuda T
TI - Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors.
SO - Eur Urol 2002 May;41(5):540-5; discussion 545
AD - Department of Urology, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka 570-8507, Japan.
OBJECTIVES: The outcome of laparoscopic partial nephrectomy using a microwave tissue coagulator for treatment of small renal tumors was with small renal tumors of less than 5.0cm in diameter (1.0-5.0cm, T1N0M0) underwent retroperitoneoscopic partial nephrectomy. To control bleeding during the partial nephrectomy, the renal parenchyma around the tumor was coagulated using a microwave tissue coagulator with a needle of 1.5cm length. The tumor was circumscribed within the coagulated area with 8-13 punctures of the coagulation needle, and partial nephrectomy was performed using scissors and bipolar forceps.RESULTS: All eight patients successfully underwent the procedure retroperitoneoscopically. The average operative time was 295 minutes and the average blood loss was 129ml. Three patients showed urine leakage from the renal calyces, which was controlled by suturing retroperitoneoscopically. In two patients, the surgical margin was revealed to be positive for renal cell carcinoma by frozen section pathology and additional resection was performed in these individuals. The patients were discharged from the hospital with almost full convalescence on day 10 on average. Within the mean follow-up period of 10.4 months, no recurrence was found when examined with computer tomography (CT) using contrast media. As a complication, one patient experienced a decrease in function of the operated kidney caused by unknown reason.CONCLUSION: Retroperitoneal partial nephrectomy using a microwave tissue coagulator is useful for treatment of small renal tumors located at the peripheral area of the kidney. Bleeding from the renal parenchymal incision site is well controlled without occlusion of the renal artery with additional use of a bipolar coagulator, when necessary. Further experience and long-term follow-up are mandatory however, to establish the usefulness of this technique.
UI - 12081763
AU - Ozer E; Yorukoglu K; Sagol O; Mungan U; Demirel D; Tuzel E; Kirkali Z
TI - Prognostic significance of nuclear morphometry in renal cell carcinoma.
SO - BJU Int 2002 Jul;90(1):20-5
AD - Department of Pathology, Dokuz Eylul University School of Medicine, Inciralti, Izmir, Turkey.
OBJECTIVE: To assess nuclear morphometry as a predictor of prognosis in patients with renal cell carcinoma (RCC). PATIENTS AND METHODS: The study included 65 consecutive patients with RCC who underwent radical nephrectomy and were followed up for a median (range) of 80 (27-138) months. Nuclear morphometry was assessed using a computer-assisted image analysis system on histological sections and characterized by five nuclear variables (area, perimeter, major and minor diameter, and form factor). From the patients' records and pathology specimens, the clinicopathological prognostic variables (histological type, Fuhrman grade and pathological stage) were recorded. The proliferative activity was assessed using immunohistochemical staining with Ki-67 antibody. RESULTS: Higher values of mean nuclear area, perimeter, and major and minor diameter were significantly related to higher nuclear grade, proliferative activity and advanced tumour stage. They were significant predictors of disease progression and survival, together with grade, stage, sarcomatoid histology and proliferative activity. Of all significant prognostic factors predicting progression-free survival, only stage was independent (T4 vs T1, hazard ratio 6.55, 95% CI 1.63-26.13, P=0.008). CONCLUSION: Although the significance of these preliminary results must not be overstated, nuclear morphometry might provide significant prognostic information in predicting survival and tumours at high risk of progression in RCC.
UI - 12081764
AU - Griffiths DF; Verghese A; Golash A; Kynaston HG; Matthews PN; Hart AJ;
TI - Court JB Contribution of grade, vascular invasion and age to outcome in clinically localized renal cell carcinoma.
SO - BJU Int 2002 Jul;90(1):26-31
AD - Department of Pathology, University of Wales College of Medicine, Cardiff, UK. firstname.lastname@example.org
OBJECTIVE: To determine the relative prognostic importance of microvascular invasion in apparently localized renal cell carcinoma (RCC). PATIENTS AND METHODS: A retrospective clinical and pathological review was conducted of 176 consecutive patients identified from pathology records who had a nephrectomy for RCC with a median follow-up of 44 months. Vascular invasion was recorded and categorized by the level of microvascular invasion (MVI), renal vein invasion (RVI) and inferior vena cava invasion (IVCI). Tumour type, grade and size were also assessed. These variables were assessed by univariate and multivariate analysis to determine their effect on disease-free survival. RESULTS: In the univariate analysis tumour size, grade, vascular invasion and young age each predicted reduced disease-free survival. On multivariate analysis for all 176 patients, grade, vascular invasion and young age were the significant independent predictors of reduced disease-free survival. In a subgroup of 149 patients from whom those with very high risk determinants were excluded (those with grade 4 tumours and/or IVCI) most of the risk of metastasis could be accounted for by vascular invasion and young age alone (MVI vs no vascular invasion, hazard ratio 3.18, 95% confidence interval 1.29-7.84; RVI vs no vascular invasion 2.41, 0.989-5.89; and age per year 0.963, 0.94-0.992). CONCLUSIONS: Grade, vascular invasion and young age are the main independent predictors of relapse in clinically localized RCC after nephrectomy. For most patients, who do not have very high risk indicators, the main adverse predictors are vascular invasion and young age. These findings are important when selecting patients for trials of adjuvant therapy and have implications for pathological staging.
UI - 12081765
AU - Onishi T; Oishi Y; Goto H; Yanada S; Abe K
TI - Gender as a prognostic factor in patients with renal cell carcinoma.
SO - BJU Int 2002 Jul;90(1):32-6
AD - Department of Urology, Aoto University Hospital, Jikei University School of Medicine, Tokyo, Japan. email@example.com
OBJECTIVE: To evaluate gender as a prognostic factor in patients with renal cell carcinoma (RCC), using a retrospective review of patients with RCC stratified according to gender and analysing factors affecting patients with pathologically defined RCC (all of whom underwent nephrectomy) were classified as having clear cell carcinoma in 662 (follow-up in 648), papillary RCC in 43 (follow-up in 42), chromophobe cell carcinoma in 36 (follow-up in 34) and cyst-associated RCC in 27 (all followed up) according to the criteria proposed by the World Health Organization. The survival rates were compared between men and women, calculated and stratified according to the subtype of RCC. RESULTS: There tended to be a more favourable prognosis in women than in men but the difference was not quite significant (P=0.061). Of those with clear cell carcinoma, women had a more favourable prognosis than men and the difference in survival was significant (P=0.012). No other subtype of RCC was associated with a significant difference in survival between the sexes. There was a smaller proportion of patients with stage IV and a larger proportion with stage I disease in women than in men (P<0.05). Of stage I patients, women had a more favourable prognosis than men (P<0.011). Women had better survival after recurrence than had men, the difference being significant (P=0.007). CONCLUSION: The prognosis is significantly better in women than men with clear cell carcinoma. The factors that contribute to a favourable prognosis in women are the greater proportion of lower stage disease and better survival after recurrence.
UI - 12185060
AU - Israel GM; Bosniak MA; Slywotzky CM; Rosen RJ
TI - CT differentiation of large exophytic renal angiomyolipomas and perirenal liposarcomas.
SO - AJR Am J Roentgenol 2002 Sep;179(3):769-73
AD - Department of Radiology, Division of Abdominal Imaging, HW 202, New York University Medical Center, 560 First Ave., New York, NY 10016, USA.
OBJECTIVE: The purpose of our study was to describe the imaging findings and CT characteristics that lead to accurate distinction of large exophytic renal angiomyolipomas from retroperitoneal perirenal liposarcomas, which at times can be confused on imaging studies and even at pathologic examination. MATERIALS AND METHODS: We retrospectively analyzed CT images of 15 large exophytic renal angiomyolipomas and 12 well-differentiated perirenal liposarcomas. Pathologic correlation was available for six of 15 angiomyolipomas and all of the liposarcomas. All examinations were evaluated for lesion size, renal parenchymal defect, enlarged vessels, kidney displacement, lesion encapsulation or margination, associated hemorrhage, and additional angiomyolipomas. The records of patients with tuberous sclerosis or the forme fruste of that condition were excluded from the study. RESULTS: The average size of the angiomyolipomas was 14 x 10 cm. They showed a renal parenchymal defect (n = 15), enlarged vessels (n = 12), renal displacement (n = 14), good margination without a distinct capsule (n = 14), hemorrhage (n = 1), and additional (one or two) angiomyolipomas (n = 4). The average size of the liposarcomas was 18 x 11.6 cm. They showed enlarged vessels (n = 3), renal displacement (n = 11), and encapsulation (n = 4); none showed a renal parenchymal defect, hemorrhage, or associated angiomyolipomas. CONCLUSION: Although large exophytic angiomyolipomas and well-differentiated retroperitoneal liposarcomas may have similar appearances on imaging, careful evaluation for a defect in the renal parenchyma combined with the presence of enlarged vessels in angiomyolipomas should enable accurate differentiation in almost all cases. Achieving an accurate diagnosis can have a significant impact on patient treatment.
UI - 12197223
AU - Bellmunt J; Cos J; Cleries R; Perez M; Ribas A; Eres N; Murio JE;
TI - Margarit C; Baselga J Feasibility trial of methotrexate-paclitaxel as a second line therapy in advanced urothelial cancer.
SO - Cancer Invest 2002;20(5-6):673-85
AD - Medical Oncology Service, Hospital General Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. firstname.lastname@example.org
To evaluate the clinical value of the concurrent use of methotrexate administered immediately before paclitaxel, we investigated the efficacy and toxicity of this two-drug combination administered as palliative second line therapy in patients with advanced urothelial cancer. The design of the schedule and sequence used was based on our previous preclinical data from a comparative study on sequential combinations of paclitaxel and methotrexate in a human bladder cancer cell line. As a confirmation study, we further extended our analysis of in vitro synergism. Twenty patients with advanced transitional cell carcinoma of the urinary tract previously treated with platinum-based therapy, with adequate renal function and a performance status > or = 60 were considered eligible. They received therapy with methotrexate 30 mg/m2 administered as an intravenous bolus, followed immediately by paclitaxel 175 mg/m2 given as a 3-hr infusion, both on day 1 every 21 days. Therapy was given on a compassionate-use basis until either disease progression was documented or the patient became intolerant to therapy. In vitro data were further analyzed using the median-effect principle and the combination index method. Twenty patients with metastatic (16 patients) or locally advanced disease (four patients) received a median of three cycles of therapy. Of the 19 patients assessable for response, there were six partial responses and seven disease stabilizations with no complete responses. Median duration of response was 3 months (range, 2-7) and median survival was 5 months. Three patients developed grade 3-4 neutropenia, one patient had grade 3 anemia, four patients had grade 2-3 sensory neuropathy, and three patients had myalgias. Eighteen patients developed alopecia. Gastrointestinal toxicity was mild. One patient died after the first cycle due to pulmonary thrombo-embolism and could not be evaluated for response. The synergistic in vitro effect of the concurrent combination was confirmed in analyses performed under mutually exclusive and mutually nonexclusive criteria. In conclusion, the combination of methotrexate and paclitaxel at this dose and sequence is feasible and active as a palliative therapy in patients with advanced urothelial cancer previously treated with platinum-based therapies. This schedule merits further investigation in a phase-II trial.
UI - 12133074
AU - Bernues M; Casadevall C; Caballin MR; Egozcue J; Miro R
TI - DNA hypermethylation at the D17S5 locus is not a frequent event in human urothelial cancer.
SO - BJU Int 2002 Aug;90(3):332-5
AD - Institut de Biologia Fonamental, Universitat Autonoma de Barcelona, Barcelona, Spain. email@example.com
OBJECTIVE: To analyse the DNA methylation status and the loss of heterozygosity (LOH) at the D17S5 locus (17p13.3) in urothelial cancer. MATERIALS AND METHODS: DNA methylation was assayed and LOH analysed by Southern blotting in a series of 33 transitional cell carcinomas of the bladder and renal pelvis. RESULTS: DNA hypermethylation and LOH at the D17S5 locus were detected in six (18%) and 17 (52%) of the tumours, respectively. The six cases with DNA hypermethylation were of the papillary type, and four also had LOH at this locus. CONCLUSION: In contrast to other epithelial tumours, DNA hypermethylation at the D17S5 locus is not a frequent event in human urothelial cancer.
UI - 12100917
AU - Yaycioglu O; Rutman MP; Balasubramaniam M; Peters KM; Gonzalez JA
TI - Clinical and pathologic tumor size in renal cell carcinoma; difference, correlation, and analysis of the influencing factors.
SO - Urology 2002 Jul;60(1):33-8
AD - Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA.
OBJECTIVES: To investigate the relation between the clinical and pathologic size and to identify the factors that affect this relationship. The clinical size of the tumor is essential for choosing the appropriate treatment in renal cell carcinoma. The pathologic size, on the other hand, is an important prognostic indicator. METHODS: We reviewed the charts of 291 open nephrectomy patients treated for nonmetastatic renal cell carcinoma. Clinical size was defined as the largest diameter on contrast-enhanced computed tomography. Pathologic size was defined as the largest diameter on pathologic examination. The clinical and pathologic sizes were compared, and their correlation was analyzed. The effect of various clinical and pathologic factors on the percentage of the size difference (%Delta(size)) was analyzed. RESULTS: The mean clinical and pathologic size was 5.4 +/- 3.2 and 5.3 +/- 3.3 cm, respectively. The difference was not significant (P = 0.1679). The clinical and pathologic size also correlated highly (r = 0.9540; P <0.0001). The estimated blood loss, local tumor extension, and cell type had significant influence on the %Delta(size) (P = 0.0018, 0.0415, and 0.0079, respectively). Additionally, in approximately one half of the patients with the greatest size difference, features such as cystic masses, hemorrhage, pyelonephritis, localization near or invasion of the collecting system, cysts or dilated calices adjacent to the tumor, and multiple cysts within the kidney were present, which were identified as factors that might have influenced the accuracy of the clinical size. CONCLUSIONS: The overall accuracy of the clinical size and its correlation with the pathologic size was acceptable. However, the presence of the above-mentioned factors should be taken into consideration during the interpretation of clinical tumor size.
UI - 12174939
AU - Hamada I; Kato M; Okada K
TI - Multi-cytokine therapy for advanced renal cell carcinoma: determination of the minimal effective dose.
SO - Anticancer Res 2002 Jul-Aug;22(4):2429-36
AD - Department of Urology, Saitama Medical School, Iruma-Gun, Japan.
A low-dose cytokine combination therapy was given continuously for as extended period to seven patients with advanced renal cell carcinoma to investigate adverse reactions and anti-cancer effectiveness. These cases were: five patients with metastasis; one whose surgical removal of metastatic foci resulted in a non-curative operation; and one patient administered our regimen as postoperative treatment for locally-advanced cancer. Our regimen was started with a subcutaneous injection of a two-drug combination: 6x10(6) units interferon-alfa (IFN-alpha) and 1x10(6) units interferon-gamma (IFN-gamma) to per week iwall our patients; subcutaneous injection of 1.4x10(6) units interleukin-2 (IL-2) per week was added for three patients who showed insufficient therapeutic effects. The combination therapy was performed for 31 months maximum. Objective adverse reactions were very slight in all patients, thus they could be treated as outpatients. Therapeutic outcomes of IFN-alpha and IFN-gamma combination therapy were assessed as CR in one, PR in one, NC in 2 and PID in one patient. One patient showed NC for 27 months. Three patients, one PR case, one NC case and one PD case, were shifted to the three-drug combination therapy and the results after shifting were assessed as 2 PR cases and one PD case. These 2 PR cases are still under treatment with a good quality of life after 31 and 24 months, respectively. These results suggest the possibility of prolonging survival-time by combining continuous low-dose cytokine with conventional local treatments.
UI - 12197170
AU - Balaz V; Schlegel D; Hampl F; Vrsansky D
TI - [Surgical treatment of renal carcinoma and thrombosis of the inferior vena cava]
SO - Rozhl Chir 2002 Jul;81(7):352-6
AD - Urologicke oddelenie NsP F. D. Roosevelta, Banska Bystrica, Slovenska republika. firstname.lastname@example.org
INTRODUCTION: In Slovakia every year some 600 renal carcinomas are diagnosed. This number includes 5 to 10% carcinomas with a tumours thrombus is the renal vein or inferior vena cava. The objective of the present work is to describe diagnostic and surgical methods is patients with this disease. MATERIAL AND METHODS: The authors describe the surgical procedures, depending on the level of the tumours thrombus in the inferior vena cava in a group of 22 patients operated at the Urological department of the F. D. Roosevelt Hospital in Banska Bystrica in 1997 to 2001. RESULTS: In all 22 patients the tumours thrombus was removed along with the tumours kidney. In two instances the thrombus reached as far as the right atrium and in 4 patients with a tumours thrombus in a subdiaphragmatic position extracorporeal circulation was used. There was no death in conjunction with the surgical operation. There was one complication caused by haemorrhage which called for surgical revision. Eight patients died during the investigation period as a result of a relapse and generalization of the disease. CONCLUSION: Based on the authors' experience and data in the literature the authors recommend surgery of the kidney with a tumours thrombus of the inferior vena cava as safe treatment in special hospital departments.
UI - 12043233
AU - Markina EA; Odintsov SV; Vinogradova NN
TI - [Renal carcinoma: active detection in regular check-ups]
SO - Ter Arkh 2002;74(4):22-5
AIM: To improve early diagnosis of renal carcinoma (RC) in the course of check-ups. MATERIAL AND METHODS: Regular checkups performed in 1980-1999 detected 715 cases of renal carcinoma. Among the patients were 452 male (60.2%) and 263 female (39.8%) patients. Mean age was 66 years. Screening methods for healthy examinees and risk group examinees, RC incidence rate, 1 year lethality and survival were assessed. RESULTS: Mean RC incidence rate in men was 80.9, in women 34.9 per 100,000. Early diagnosis of RC stage I and II made up 58.4 in men and 59.4% in women. Significantly more patients with RC stage I and II were diagnosed at checkup than among those seeking medical advice. 5-year corrected survival in males was 80%, 10-year survival--74%, in females--84 and 80%, respectively. CONCLUSION: Check-up raised early diagnosis of RC stage I and II up to 82.3%. This, in its turn, improved survival of RC patients.
UI - 11937758
AU - Gerritsen ME; Peale FV Jr; Wu T
TI - Gene expression profiling in silico: relative expression of candidate angiogenesis associated genes in renal cell carcinomas.
SO - Exp Nephrol 2002;10(2):114-9
AD - Department of Cardiovascular Research, Genentech, South San Francisco, CA, USA. email@example.com
Recent advances in gene expression profiling have led to the development of comprehensive databases which can be queried in various manners. In the present report, we have taken a list of genes previously associated with angiogenesis, either in in vivo or in in vitro models, and queried a commercial database established by GeneLogic to determine the relative expression of these candidate genes in normal kidneys and in renal cell carcinomas (RCC). We identified a number of genes, including CXCR4, matrix metalloproteinase 9, thrombospondin 2, and vascular endothelial growth factor, that were highly expressed in RCC versus normal tissue. One gene, hevin, appears to be selectively upregulated in RCC in contrast to downregulation of this gene in lung and colon tumors. This approach provides a powerful means to identify potential markers of tumor vascularization. Copyright 2002 S. Karger AG, Basel
UI - 12173893
AU - Foley KA; El-Jack MS; Hegarty J
TI - Retroperitoneoscopic nephrectomy: the experience of an Irish teaching hospital.
SO - Ir J Med Sci 2002 Apr-Jun;171(2):76-8
AD - Department of Surgery, Waterford Regional Hospital, Ireland. firstname.lastname@example.org
BACKGROUND: Since its introduction, laparoscopic nephrectomy is increasingly being used worldwide as a method of removing the kidney, both in benign disease and in small volume tumours. To our knowledge, we are the first surgeons in Ireland to perform this procedure with results that support its use in select cases. AIMS: We looked at 12 cases of retroperitoneal laparoscopic nephrectomy, which we carried out over a five-year period. METHODS: Of the 12 cases performed, five were for renal cell carcinoma and seven were for benign disease. Regarding patients with carcinoma, careful patient selection was based on physical examination, biochemical renal profile and tumour stage. RESULTS: Mean tumour size was 3.3cm. Mean specimen weight was 184g (carcinoma) and 42g (benign). Mean surgical time was 90 minutes and average blood loss was 45ml. Average length of hospital stay was 3.5 days. No major complications occurred. Follow-up of those with renal cell carcinoma revealed all to be tumour-free and renal profile studies of all patients fell within the normal range for all parameters. CONCLUSIONS: Our results support previous reports that recommend laparoscopic nephrectomy as a method for removing kidneys with benign disease or with small volume carcinomas.
UI - 12209689
AU - Atzpodien J; Hoffmann R; Franzke M; Stief C; Wandert T; Reitz M
TI - Thirteen-year, long-term efficacy of interferon 2alpha and interleukin 2-based home therapy in patients with advanced renal cell carcinoma.
SO - Cancer 2002 Sep 1;95(5):1045-50
AD - Medizinische Hochschule Hannover, Germany. email@example.com
BACKGROUND: The goal of the current report was to demonstrate the long-term efficacy of outpatient subcutaneous (sc) interferon alpha (IFN-alpha) and sc interleukin 2 (IL-2)-based combination regimens in patients with metastatic renal cell carcinoma. METHODS: In three consecutive clinical trials, 443 patients received combined sc IFN-alpha and sc IL-2 (n = 97 patients); combined sc IFN-alpha, sc IL-2, and intravenous (iv) 5-fluorouracil (5-FU) (n = 260 patients); or combined sc IFN-alpha, sc IL-2, and iv 5-FU with oral 13cis-retinoic acid (n = 86 patients). RESULTS: The median overall survival was 21+ months. The 2-year, 5-year, and 13-year survival rates were calculated at 45.26%, 15.96%, and 8.96%, respectively. The median time to disease progression was 6 months. The 2-year, 5-year, and 13-year progression free survival rates were 17.84%, 9.54%, and 9.20%, respectively. CONCLUSIONS: The current data suggest that combined outpatient sc IFN-alpha and sc IL-2, according to the Atzpodien regimen, achieves long-term survival benefits in a subset of patients with metastatic renal cell carcinoma, both with and without 13-cis-retinoic acid and/or 5-fluorouracil. Copyright 2002 American Cancer Society.
UI - 10402173
AU - Kim HJ; Park JK; Kim YG
TI - Suppression of NF-kappaB activation in normal T cells by supernatant fluid from human renal cell carcinomas.
SO - J Korean Med Sci 1999 Jun;14(3):299-303
AD - Department of Urology, Institute for Medical Science, Chonbuk National