Cancer Research and Treatment

Original Articles

Genitourinary cancer

Favorable Immunotherapy Plus Tyrosine Kinase Inhibition Outcome of Renal Cell Carcinoma Patients with Low CDK5 Expression: Xianglai Xu, Ying Wang, Zhaoyi Chen, Yanjun Zhu, Jiajun Wang, Jianming Guo; Cancer Res Treat. 2023;55(4):1321-1336. Published online April 3, 2023; DOI: https://doi.org/10.4143/crt.2022.1532

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Purpose
Immunotherapy (IO) plus tyrosine kinase inhibitor (TKI) has become the first-line treatment for advanced renal cell carcinoma, despite the lack of prognostic biomarkers. Cyclin-dependent kinase 5 (CDK5) affects the tumor microenvironment, which may influence the efficacy of TKI+IO.
Materials and Methods
Two cohorts from our center (Zhongshan Metastatic Renal Cell Carcinoma [ZS-MRCC] cohort, Zhongshan High-risk Localized Renal Cell Carcinoma [ZS-HRRCC] cohort) and one cohort from a clinical trial (JAVELIN-101) were enrolled. The expression of CDK5 of each sample was determined by RNA sequencing. Immune infiltration and T cell function were evaluated by flow cytometry and immunohistochemistry. Response and progression-free survival (PFS) were set as primary endpoints.
Results
Patients of low CDK5 expression showed higher objective response rate (60.0% vs. 23.3%) and longer PFS in both cohorts (ZS-MRCC cohort, p=0.014; JAVELIN-101 cohort, p=0.040). CDK5 expression was enhanced in non-responders (p < 0.05). In the ZS-HRRCC cohort, CDK5 was associated with decreased tumor-infiltrating CD8+ T cells, which was proved by immunohistochemistry (p < 0.05) and flow cytometry (Spearman’s ρ=–0.49, p < 0.001). In the high CDK5 subgroup, CD8+ T cells revealed a dysfunction phenotype with decreased granzyme B, and more regulatory T cells were identified. A predictive score was further constructed by random forest, involving CDK5 and T cell exhaustion features. The RFscore was also validated in both cohorts. By utilizing the model, more patients might be distinguished from the overall cohort. Additionally, only in the low RFscore did TKI+IO outperform TKI monotherapy.
Conclusion
High-CDK5 expression was associated with immunosuppression and TKI+IO resistance. RFscore based on CDK5 may be utilized as a biomarker to determine the optimal treatment strategy.

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SPP1 expression indicates outcome of immunotherapy plus tyrosine kinase inhibition in advanced renal cell carcinoma
Xianglai Xu, Jinglai Lin, Jiahao Wang, Ying Wang, Yanjun Zhu, Jiajun Wang, Jianming Guo
Human Vaccines & Immunotherapeutics.2024;[Epub] CrossRef
Efficacy and Safety of Immuno-Oncology Plus Tyrosine Kinase Inhibitors as Late-Line Combination Therapy for Patients with Advanced Renal Cell Carcinoma
Shuzo Hamamoto, Yoshihiko Tasaki, Toshiharu Morikawa, Taku Naiki, Toshiki Etani, Kazumi Taguchi, Shoichiro Iwatsuki, Rei Unno, Tomoki Takeda, Takashi Nagai, Kengo Kawase, Yoshihisa Mimura, Yosuke Sugiyama, Atsushi Okada, Yoko Furukawa-Hibi, Takahiro Yasui
Journal of Clinical Medicine.2024; 13(12): 3365. CrossRef
PSMD2 overexpression as a biomarker for resistance and prognosis in renal cell carcinoma treated with immune checkpoint and tyrosine kinase inhibitors
Xianglai Xu, Jiahao Wang, Ying Wang, Yanjun Zhu, Jiajun Wang, Jianming Guo
Cellular Oncology.2024; 47(5): 1943. CrossRef
External validation of hemoglobin and neutrophil levels as predictors of the effectiveness of ipilimumab plus nivolumab for treating renal cell carcinoma
Shuzo Hamamoto, Yoshihiko Tasaki, Shimpei Yamashita, Junya Furukawa, Kazutoshi Fujita, Ryotaro Tomida, Makito Miyake, Noriyuki Ito, Hideto Iwamoto, Yosuke Sugiyama, Kazumi Taguchi, Takahiro Yasui
Frontiers in Oncology.2024;[Epub] CrossRef

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PD-L1 Upregulation by the mTOR Pathway in VEGFR-TKI–Resistant Metastatic Clear Cell Renal Cell Carcinoma: Se Un Jeong, Hee Sang Hwang, Ja-Min Park, Sun Young Yoon, Su-Jin Shin, Heounjeong Go, Jae-Lyun Lee, Gowun Jeong, Yong Mee Cho; Cancer Res Treat. 2023;55(1):231-244. Published online March 2, 2022; DOI: https://doi.org/10.4143/crt.2021.1526

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Purpose
Tyrosine kinase inhibitors (TKI) targeting vascular endothelial growth factor receptor (VEGFR) signaling pathways have been used for metastatic clear cell renal cell carcinoma (mCCRCC), but resistance to the drug develops in most patients. We aimed to explore the underlying mechanism of the TKI resistance with regard to programmed death-ligand 1 (PD-L1) and to investigate signaling pathway associated with the resistant mechanism.
Materials and Methods
To determine the mechanism of resistance, 10 mCCRCC patients from whom tumor tissues were harvested at both the pretreatment and the TKI-resistant post-treatment period were included as the discovery cohort, and their global gene expression profiles were compared. A TKI-resistant renal cancer cell line was established by long-term treatment with sunitinib.
Results
Among differentially expressed genes in the discovery cohort, increased PD-L1 expression in post-treatment tissues was noted in four patients. Pathway analysis showed that PD-L1 expression was positively correlated with the mammalian target of rapamycin (mTOR) signaling pathway. The TKI-resistant renal cancer cells showed increased expression of PD-L1 and mTOR signaling proteins and demonstrated aggressive tumoral behaviour. Treatment with mTOR inhibitors down-regulated PD-L1 expression and suppressed aggressive tumoral behaviour, which was reversed with stimulation of the mTOR pathway.
Conclusion
These results showed that PD-L1 expression may be increased in a subset of VEGFR-TKI–resistant mCCRCC patients via the mTOR pathway.

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IFITM3-mediated activation of TRAF6/MAPK/AP-1 pathways induces acquired TKI resistance in clear cell renal cell carcinoma
Se Un Jeong, Ja-Min Park, Sun Young Yoon, Hee Sang Hwang, Heounjeong Go, Dong-Myung Shin, Hyein Ju, Chang Ohk Sung, Jae-Lyun Lee, Gowun Jeong, Yong Mee Cho
Investigative and Clinical Urology.2024; 65(1): 84. CrossRef
Targeting apoptosis in clear cell renal cell carcinoma
Adam Kowalewski, Jędrzej Borowczak, Mateusz Maniewski, Karol Gostomczyk, Dariusz Grzanka, Łukasz Szylberg
Biomedicine & Pharmacotherapy.2024; 175: 116805. CrossRef
Therapeutic advances of targeting receptor tyrosine kinases in cancer
Ciprian Tomuleasa, Adrian-Bogdan Tigu, Raluca Munteanu, Cristian-Silviu Moldovan, David Kegyes, Anca Onaciu, Diana Gulei, Gabriel Ghiaur, Hermann Einsele, Carlo M. Croce
Signal Transduction and Targeted Therapy.2024;[Epub] CrossRef
Mechanisms of sunitinib resistance in renal cell carcinoma and associated opportunities for therapeutics
Yunxia Wang, Xiaolin Liu, Luyao Gong, Weihong Ding, Wenjing Hao, Yeheng Peng, Jun Zhang, Weimin Cai, Yuan Gao
British Journal of Pharmacology.2023; 180(23): 2937. CrossRef
Prior Anti-Angiogenic TKI-Based Treatment as Potential Predisposing Factor to Nivolumab-Mediated Recurrent Thyroid Disorder Adverse Events in mRCC Patients: A Case Series
Luigi Liguori, Angelo Luciano, Giovanna Polcaro, Alessandro Ottaiano, Marco Cascella, Francesco Perri, Stefano Pepe, Francesco Sabbatino
Biomedicines.2023; 11(11): 2974. CrossRef

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Risk Factors and Patterns of Locoregional Recurrence after Radical Nephrectomy for Locally Advanced Renal Cell Carcinoma: Gyu Sang Yoo, Won Park, Hongryull Pyo, Byong Chang Jeong, Hwang Gyun Jeon, Minyong Kang, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi, Byung Kwan Park, Chan Kyo Kim, Sung Yoon Park, Ghee Young Kwon; Cancer Res Treat. 2022;54(1):218-225. Published online April 15, 2021; DOI: https://doi.org/10.4143/crt.2020.1373

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Purpose
We aimed to investigate the risk factors and patterns of locoregional recurrence (LRR) after radical nephrectomy (RN) in patients with locally advanced renal cell carcinoma (RCC).
Materials and Methods
We retrospectively analyzed 245 patients who underwent RN for non-metastatic pT3-4 RCC from January 2006 to January 2016. We analyzed the risk factors associated with poor locoregional control using Cox regression. Anatomical mapping was performed on reference computed tomography scans showing intact kidneys.
Results
The median follow-up duration was 56 months (range, 1 to 128 months). Tumor extension to renal vessels or the inferior vena cava (IVC) and Fuhrman’s nuclear grade IV were identified as independent risk factors of LRR. The 5-year actuarial LRR rates in groups with no risk factor, one risk factor, and two risk factors were 2.3%, 19.8%, and 30.8%, respectively (p < 0.001). The locations of LRR were distributed as follows: aortocaval area (n=2), paraaortic area (n=4), retrocaval area (n=5), and tumor bed (n=11). No LRR was observed above the celiac axis (CA) or under the inferior mesenteric artery (IMA).
Conclusion
Tumor extension to renal vessels or the IVC and Fuhrman’s nuclear grade IV were the independent risk factors associated with LRR after RN for pT3-4 RCC. The locations of LRR after RN for RCC were distributed in the tumor bed and regional lymphatic area from the bifurcation of the CA to that of the IMA.

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Survival pattern of metastatic renal cell carcinoma patients according to WHO/ISUP grade: a long-term multi-institutional study
Joongwon Choi, Seokhwan Bang, Jungyo Suh, Chang Il Choi, Wan Song, Hyeong Dong Yuk, Chan Ho Lee, Minyong Kang, Seol Ho Choo, Jung Kwon Kim, Hyung Ho Lee, Jung Ki Jo, Eu Chang Hwang, Chang Wook Jeong, Young Hwii Ko, Jae Young Park, Cheryn Song, Seong Il Se
Scientific Reports.2024;[Epub] CrossRef
Adjuvant Therapy for High-Risk Localized Renal Cell Carcinoma: Current Landscape and Future Direction
Dylan M Buller, Maria Antony, Benjamin T Ristau
OncoTargets and Therapy.2023; Volume 16: 49. CrossRef

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Genitourinary Cancer

Ferroportin and FBXL5 as Prognostic Markers in Advanced Stage Clear Cell Renal Cell Carcinoma: Cheol Keun Park, Jayoon Heo, Won Sik Ham, Young-Deuk Choi, Sang Joon Shin, Nam Hoon Cho; Cancer Res Treat. 2021;53(4):1174-1183. Published online March 17, 2021; DOI: https://doi.org/10.4143/crt.2021.031

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Purpose
Advanced stage clear cell renal cell carcinoma (ccRCC) involves a poor prognosis. Several studies have reported that dysfunctions in iron metabolism‒related proteins may cause tumor progression and metastasis of this carcinoma. In this study, we investigated the impact of the expression of iron metabolism‒related proteins on patient prognoses in advanced stage ccRCCs.
Materials and Methods
All of 143 advanced stage ccRCC specimens were selected following validation with double blind reviews. Several clinicopathological parameters including nuclear grade, perirenal fat invasion, renal sinus fat invasion, vascular invasion, necrosis, and sarcomatoid/rhabdoid differentiation were compared with the expression of ferroportin (FPN), and F-Box and leucine rich repeat protein 5 (FBXL5), by immunohistochemistry. FPN and FBXL5 mRNA level of ccRCC from The Cancer Genome Atlas database were also analyzed for validation.
Results
FPN and FBXL5 immunohistochemistry showed membrane and cytoplasmic expression, respectively. Based on the H-score, cases were classified as low or high expression with a cutoff value of 20 for FPN and 15 for FBXL5, respectively. Low expression of FPN and FBXL5 were significantly associated with patient death (p=0.022 and p=0.005, respectively). In survival analyses, low expression of FPN and FBXL5 were significantly associated with shorter overall survival (p=0.003 and p=0.004, respectively). On multivariate analysis, low expression of FBXL5 (hazard ratio, 2.001; p=0.034) was significantly associated with shorter overall survival.
Conclusion
FPN and FBXL5 can be used as potential prognostic markers and therapeutic targets for advanced stage ccRCC.

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Differences in genomic profile of high-grade urothelial carcinoma according to tumor location
Cheol Keun Park, Nam Hoon Cho
Urologic Oncology: Seminars and Original Investigations.2022; 40(3): 109.e1. CrossRef
The Role of Iron in Cancer Progression
Qianqian Guo, Liwen Li, Shanshan Hou, Ziqiao Yuan, Chenhui Li, Wenzhou Zhang, Lufeng Zheng, Xiaoman Li
Frontiers in Oncology.2021;[Epub] CrossRef

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Temsirolimus in Asian Metastatic/Recurrent Non-clear Cell Renal Carcinoma: Jii Bum Lee, Hyung Soon Park, Sejung Park, Hyo Jin Lee, Kyung A Kwon, Young Jin Choi, Yu Jung Kim, Chung Mo Nam, Nam Hoon Cho, Beodeul Kang, Hyun Cheol Chung, Sun Young Rha; Cancer Res Treat. 2019;51(4):1578-1588. Published online April 16, 2019; DOI: https://doi.org/10.4143/crt.2018.671

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Purpose
Temsirolimus is effective in the treatment for metastatic non-clear cell renal cell carcinoma (nccRCC) with poor prognosis. We aim to investigate the efficacy and tolerability of temsirolimus in treatment of naïve Asian patients with metastatic/recurrent nccRCC.
Materials and Methods
From January 2008 to July 2017, data of treatment-naïve, metastatic/recurrent nccRCC patients, who were treated with temsirolimus according to the standard protocol, were collected. The primary end-point was progression-free survival (PFS). Secondary end points were overall survival (OS), objective response rate (ORR), and tolerability of temsirolimus.
Results
Forty-four metastatic/recurrent nccRCC patients, 10 from prospective and 34 from retrospective groups, were enrolled; 24 patients (54%) were papillary type, and other histology subtypes included 11 chromophobes (25%), two collecting ducts (5%), one Xp11.2 translocation (2%), and six others (14%). The median PFS and OS were 7.6 months and 17.6 months, res-pectively. ORR was 11% and disease control rate was 83%. Patients with prior nephrectomy had longer PFS (hazard ratio [HR], 0.16; 95% confidence interval [CI], 0.06 to 0.42; p < 0.001) and OS (HR, 0.15; 95% CI, 0.05 to 0.45; p < 0.001). Compared to favorable/intermediate prognosis group, poor prognosis group had shorter median PFS (4.7 months vs. 7.6 months [HR, 2.91; 95% CI, 1.39 to 6.12; p=0.005]) and median OS (9.2 months vs. 17.6 months [HR, 2.84; 95% CI, 1.23 to 6.56; p=0.015]).
Conclusion
Temsirolimus not only benefits poor-risk nccRCC patients, but it is also effective in favorable or intermediate-risk group in Asians. Temsirolimus was well-tolerated with manageable adverse events.

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Advances in non‐clear cell renal cell carcinoma management: From heterogeneous biology to treatment options
Nathaniel R. Wilson, Yusuf Acikgoz, Elshad Hasanov
International Journal of Cancer.2024; 154(6): 947. CrossRef
Cancer stem cells and angiogenesis
Yanru Yang, Jingyu Guo, Mingyang Li, Guangxin Chu, Hai Jin, Jing Ma, Qingge Jia
Pathology - Research and Practice.2024; 253: 155064. CrossRef
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Aimin Jiang, Jinxin Li, Ziwei He, Ying Liu, Kun Qiao, Yu Fang, Le Qu, Peng Luo, Anqi Lin, Linhui Wang
MedComm.2024;[Epub] CrossRef
Cost-effectiveness analysis of anlotinib versus sunitinib as first-line treatment for metastatic renal cell carcinoma in China
Jingyang Lin, Qingxia Fang, Xiaochun Zheng, Meng Li
PLOS ONE.2023; 18(2): e0281402. CrossRef
Targeted Literature Review of Outcomes to Initial Systemic Therapy for Advanced/Metastatic Non-Clear Cell Renal Cell Carcinoma in Observational Studies
Shawna R. Calhoun, Manish Sharma, Chung-Han Lee
Kidney Cancer.2023; 7(1): 123. CrossRef

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Bevacizumab Plus Erlotinib Combination Therapy for Advanced Hereditary Leiomyomatosis and Renal Cell Carcinoma-Associated Renal Cell Carcinoma: A Multicenter Retrospective Analysis in Korean Patients: Yeonjoo Choi, Bhumsuk Keam, Miso Kim, Shinkyo Yoon, Dalyong Kim, Jong Gwon Choi, Ja Young Seo, Inkeun Park, Jae Lyun Lee; Cancer Res Treat. 2019;51(4):1549-1556. Published online March 25, 2019; DOI: https://doi.org/10.4143/crt.2019.086

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Purpose
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare genetic syndrome resulting from germline mutations in fumarate hydratase. The combination of bevacizumab plus erlotinib showed promising interim results for HLRCC-associated RCC. Based on these results, we analyzed the outcome of bevacizumab plus erlotinib in Korean patients with HLRCC-associated RCC.
Materials and Methods
We retrospectively reviewed the efficacy and safety of bevacizumab plus erlotinib in patients with HLRCC-associated RCC who were confirmed to have germline mutations in fumarate hydratase. The primary endpoint was the objective response rate (ORR), while the secondary endpoints were progression-free survival (PFS) and overall survival (OS).
Result
We identified 10 patients with advanced HLRCC-associated RCC who received bevacizumab plus erlotinib. Median age at diagnosis was 41 years, and five of the patients had received the combination as first- or second-line treatments. The ORR was 50% and the median PFS and OS were 13.3 and 14.1 months, respectively. Most adverse events were predictable and manageable by conventional measures, except for one instance where a patient died of gastrointestinal bleeding.
Conclusion
This is the first real-world outcome of the treatment of advanced HLRCC-associated RCC. Bevacizumab plus erlotinib therapy showed promising activity with moderate toxicity. We should be increasingly aware of HLRCC-associated RCC and bevacizumab plus erlotinib should be a first-line treatment for this condition, unless other promising data are published.

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Application of the International Metastatic Renal Cell Carcinoma Database Consortium and Memorial Sloan Kettering Cancer Center Risk Models in Patients with Metastatic Non-Clear Cell Renal Cell Carcinoma: A Multi-Institutional Retrospective Study Using the Korean Metastatic Renal Cell Carcinoma Registry: Jung Kwon Kim, Sung Han Kim, Mi Kyung Song, Jungnam Joo, Seong Il Seo, Cheol Kwak, Chang Wook Jeong, Cheryn Song, Eu Chang Hwang, Ill Young Seo, Hakmin Lee, Sung-Hoo Hong, Jae Young Park, Jinsoo Chung, Korean Renal Cell Carcinoma Study Group; Cancer Res Treat. 2019;51(2):758-768. Published online September 7, 2018; DOI: https://doi.org/10.4143/crt.2018.421

Abstract PDF Supplementary Material PubReader ePub

Purpose
The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) and the Memorial Sloan Kettering Cancer Center (MSKCC) risk models were developed predominantly with clear cell renal cell carcinoma (RCC). Accordingly, whether these two models could be applied to metastatic non-clear cell RCC (mNCCRCC) as well has not been well-known and was investigated herein.
Materials and Methods
From the Korean metastatic RCC registry, a total of 156 patients (8.1%) with mNCCRCC among the entire cohort of 1,922 patients were analyzed. Both models were applied to predict first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS).
Results
The median first-line PFS, total PFS, and CSS were 5, 6, and 24 months, respectively. The IMDC risk model reliably discriminated three risk groups to predict survival: the median firstline PFS, total PFS, and CSS for the favorable, intermediate, and poor risk groups were 9, 5, and, 2 months (p=0.001); 14, 7, and 2 months (p < 0.001); and 41, 21, and 8 months (p < 0.001), all respectively. The MSKCC risk model also reliably differentiated three risk groups: 9, 5, and, 2 months (p=0.005); 10, 7, and 3 months (p=0.002); and 50, 21, and 8 months (p < 0.001), also all respectively. The concordance indices were 0.632 with the IMDC model and 0.643 with the MSKCC model for first-line PFS: 0.748 and 0.655 for CSS.
Conclusion
The current IMDC and MSKCC risk models reliably predict first-line PFS, total PFS, and CSS in mNCCRCC.

Citations

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Scientific Reports.2024;[Epub] CrossRef
Prognostic Factors and Treatment Outcomes in Renal Cell Carcinoma: A Comprehensive Analysis
Ömer Faruk ELÇİÇEK, Mehmet KÜÇÜKÖNER
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Machine learning based prediction for oncologic outcomes of renal cell carcinoma after surgery using Korean Renal Cell Carcinoma (KORCC) database
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Ismail Selvi, Umut Demirci, Nazan Bozdogan, Halil Basar
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Pazopanib for the Treatment of Non-clear Cell Renal Cell Carcinoma: A Single-Arm, Open-Label, Multicenter, Phase II Study: Ki Sun Jung, Su Jin Lee, Se Hoon Park, Jae-Lyun Lee, Se-Hoon Lee, Jae Yun Lim, Jung Hun Kang, Suee Lee, Sun Young Rha, Kyung Hee Lee, Ho Young Kim, Ho Yeong Lim; Cancer Res Treat. 2018;50(2):488-494. Published online May 22, 2017; DOI: https://doi.org/10.4143/crt.2016.584

Abstract PDF Supplementary Material PubReader ePub

Purpose
The optimal treatment strategy for patients with metastatic non-clear cell type renal cell carcinoma (nccRCC) remains unclear. Although several inhibitors of vascular endothelial growth factor have recently shown efficacy against nccRCC, the clinical benefit of pazopanib in nccRCC has not been analyzed. We therefore designed a single-arm, open-label, phase II study to determine the efficacy and safety of pazopanib in patients with nccRCC.
Materials and Methods
Patientswith locally advanced or metastatic nccRCC, exceptfor collecting duct or sarcomatoid type, received 800 mg/day of pazopanib daily until progression of disease or intolerable toxicity. One cyclewas defined as 4weeks and tumorresponsewas evaluated every two cycles. The primary objective was overall response rate (ORR).
Results
A total of 29 eligible patients were enrolled at nine centers in Korea from December 2012 and September 2014. The median age of the patients was 58 years (range, 27 to 76 years) and 21 patients (72%) were male. Regarding histology type, 19 patients had papillary, three had chromophobe, two had unclassified and five had unknown non-clear cell type. Of 28 evaluable patients, eight achieved a confirmed partial response with ORR of 28%. The median progression-free survival was 16.5 months (95% confidence interval, 10.9 to 22.1) and median overall survival was not reached. Sixteen patients (55%) experienced treatment-related toxicity of grade 3 or more, but most adverse events were overcome through dose reduction and delay.
Conclusion
In this prospective phase II study, pazopanib demonstrated promising activity and tolerable safety profile in patients with metastatic nccRCC.

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Nathaniel R. Wilson, Yusuf Acikgoz, Elshad Hasanov
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Papillary Renal Cell Carcinoma: Current Evidence and Future Directions
Albert Jang, Charbel S. Hobeika, Shilpa Gupta
Kidney Cancer.2024; 8(1): 61. CrossRef
Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma
Hasan Cagri Yildirim, Ertuğrul Bayram, Elvin Chalabiyev, Nargız Majidova, Tugay Avci, Halil Göksel Güzel, Caner Kapar, Mehmet Uzun, Perihan Perkin, Fahri Akgül, Saadet Sim Yildirim, Seda Sali, Anil Yildiz, Seher Nazli Kazaz, Engin Hendem, Murat Arcagok, G
Journal of Chemotherapy.2024; : 1. CrossRef
Real World Data of Diagnosis, Survival, and Treatment Outcomes in Patients With Metastatic Non Clear Cell Renal Cell Carcinoma
Floriane Izarn, Benoît Allignet, Romane Gille, Helen Boyle, Eve-Marie Neidhardt, Sylvie Négrier, Aude Fléchon
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Jason R. Brown, Adam Calaway, Erik Castle, Jorge Garcia, Pedro C. Barata
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Pazopanib as a possible option for the treatment of metastatic non-clear cell renal carcinoma patients: a systematic review
Melissa Bersanelli, Matteo Brunelli, Letizia Gnetti, Umberto Maestroni, Sebastiano Buti
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Second Primary Cancer Risk among Kidney Cancer Patients in Korea: A Population-Based Cohort Study: Jae Young Joung, Whi-An Kwon, Jiwon Lim, Chang-Mo Oh, Kyu-Won Jung, Sung Han Kim, Ho Kyung Seo, Weon Seo Park, Jinsoo Chung, Kang Hyun Lee, Young-Joo Won; Cancer Res Treat. 2018;50(1):293-301. Published online April 19, 2017; DOI: https://doi.org/10.4143/crt.2016.543

Abstract PDF Supplementary Material PubReader ePub

Purpose
Secondary primary cancers (SPCs) commonly arise in patients with renal cell carcinoma (RCC). We designed the present study to estimate the SPC incidence in Korean patients with RCC.
Materials and Methods
The study cohort was population-based and consisted of 40,347 individuals from the Korean Central Cancer Registry who were diagnosed with primary renal cancer between 1993 and 2013. Standardized incidence ratios (SIRs) for SPCs were estimated for different ages at diagnosis, latencies, diagnostic periods, and treatments.
Results
For patients with primary RCC, the risk of developing a SPC was higher than the risk of developing cancer in the general population (SIR, 1.13; 95% confidence interval, 1.08 to 1.18). Most cancer types showed higher incidences in patients with RCC than in the general population. However, the relative incidence of gastric cancer as an SPC varied by age. Gastric cancer incidence was elevated in young patients (< 30 years) with RCC, but reduced in older (≥ 30) patients with RCC. Patients with advanced RCC died prematurely, regardless of SPC development. In contrast, those with early-stage RCC survived for longer periods, although SPC development affected their post-RCC survival. After SPC development, women had better survival than men.
Conclusion
In Korean patients with primary RCC, the incidence of SPC was 13% higher than the incidence of cancer in the general population. These findings may play important roles in the conduct of follow-up evaluations and education for patients with RCC.

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Incorporating Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in Place of Neutrophil Count and Platelet Count Improves Prognostic Accuracy of the International Metastatic Renal Cell Carcinoma Database Consortium Model: Pawel Chrom, Rafal Stec, Lubomir Bodnar, Cezary Szczylik; Cancer Res Treat. 2018;50(1):103-110. Published online March 3, 2017; DOI: https://doi.org/10.4143/crt.2017.033

Abstract PDF Supplementary Material PubReader ePub

Purpose
The study investigated whether a replacement of neutrophil count and platelet count by neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model would improve its prognostic accuracy.
Materials and Methods
This retrospective analysis included consecutive patients with metastatic renal cell carcinoma treated with first-line tyrosine kinase inhibitors. The IMDC and modified-IMDC models were compared using: concordance index (CI), bias-corrected concordance index (BCCI), calibration plots, the Grønnesby and Borgan test, Bayesian Information Criterion (BIC), generalized R², Integrated Discrimination Improvement (IDI), and continuous Net Reclassification Index (cNRI) for individual risk factors and the three risk groups.
Results
Three hundred and twenty-one patients were eligible for analyses. The modified-IMDC model with NLR value of 3.6 and PLR value of 157 was selected for comparison with the IMDC model. Both models were well calibrated. All other measures favoured the modified-IMDC model over the IMDC model (CI, 0.706 vs. 0.677; BCCI, 0.699 vs. 0.671; BIC, 2,176.2 vs. 2,190.7; generalized R², 0.238 vs. 0.202; IDI, 0.044; cNRI, 0.279 for individual risk factors; and CI, 0.669 vs. 0.641; BCCI, 0.669 vs. 0.641; BIC, 2,183.2 vs. 2,198.1; generalized R², 0.163 vs. 0.123; IDI, 0.045; cNRI, 0.165 for the three risk groups).
Conclusion
Incorporation of NLR and PLR in place of neutrophil count and platelet count improved prognostic accuracy of the IMDC model. These findings require external validation before introducing into clinical practice.

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Bruce Li, Swati Sood, Melissa J. Huynh, Nicholas E. Power
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Associations between Pretreatment Body Composition Features and Clinical Outcomes among Patients with Metastatic Clear Cell Renal Cell Carcinoma Treated with Immune Checkpoint Blockade
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Exploratory Analysis of the Platelet-to-Lymphocyte Ratio Prognostic Value in the Adjuvant Renal Cell Cancer Setting
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Ruotao Xiao, Chuxiao Xu, Wei He, Lei Liu, Hongxian Zhang, Cheng Liu, Lulin Ma
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Arne Strauss, Marianne Schmid, Michael Rink, Michael Moran, Stephan Bernhardt, Marcus Hubbe, Lothar Bergmann, Katrin Schlack, Martin Boegemann
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Weipu Mao, Si Sun, Ting He, Xin Jin, Jianping Wu, Bin Xu, Guangyuan Zhang, Keyi Wang, Ming Chen
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Can Systemic Immune-Inflammation Index Create a New Perspective for the IMDC Scoring System in Patients with Metastatic Renal Cell Carcinoma?
Fatma Bugdayci Basal, Cengiz Karacin, Irem Bilgetekin, Omur Berna Oksuzoglu
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Post-surgical Regression of Thoracic Metastases After Salvage Lobectomy for Recurrent Renal Cell Carcinoma
Alessia Stanzi, Elena Verzoni, Margherita Ruggirello, Luigi Rolli, Ugo Pastorino
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Zhuo Liu, Xun Zhao, Hong-Xian Zhang, Run-Zhuo Ma, Li-Wei Li, Shi-Ying Tang, Guo-Liang Wang, Shu-Dong Zhang, Shu-Min Wang, Xiao-Jun Tian, Lu-Lin Ma
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Guilherme Nader Marta, Pedro Isaacsson Velho, Renata R. C. Bonadio, Mirella Nardo, Sheila F. Faraj, Manoel Carlos L. de Azevedo Souza, David Q. B. Muniz, Diogo Assed Bastos, Carlos Dzik
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The Clinical Significance of Routine Risk Categorization in Metastatic Renal Cell Carcinoma and its Impact on Treatment Decision-Making: A Systematic Review
Shouki Bazarbashi, Abdullah Alsharm, Faisal Azam, Hazem El Ashry, Jamal Zekri
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Patient selection and risk factors in the changing treatment landscape of metastatic renal cell carcinoma
Ehab Abdou, Ravi M. Pedapenki, Mohamed Abouagour, Abdul R. Zar, Emad Dawoud, Dalia Elshourbagy, Humaid O. Al-Shamsi, Enrique Grande
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Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor of Disease-free Survival in Postnephrectomy High-risk Locoregional Renal Cell Carcinoma: Analysis of the S-TRAC Trial
Anup Patel, Alain Ravaud, Robert J. Motzer, Allan J. Pantuck, Michael Staehler, Bernard Escudier, Jean-François Martini, Mariajose Lechuga, Xun Lin, Daniel J. George
Clinical Cancer Research.2020; 26(18): 4863. CrossRef
External validation of the systemic immune-inflammation index as a prognostic factor in metastatic renal cell carcinoma and its implementation within the international metastatic renal cell carcinoma database consortium model
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International Journal of Clinical Oncology.2019; 24(5): 526. CrossRef
Assessing Outcomes and Prognostic Factors for First-Line Therapy in Elderly Patients With Metastatic Renal Cell Carcinoma: Real-Life Data From a Single United Kingdom Institution
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Ritesh R. Kotecha, Robert J. Motzer, Martin H. Voss
Nature Reviews Clinical Oncology.2019; 16(10): 621. CrossRef
The impact of neutrophil-to-lymphocyte, platelet-to-lymphocyte and haemoglobin-to-platelet ratio on localised renal cell carcinoma oncologic outcomes
S. Albisinni, D. Pretot, W. Al Hajj Obeid, F. Aoun, T. Quackels, A. Peltier, T. Roumeguère
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The Role of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, and Platelets in the Prognosis of Metastatic Renal Cell Carcinoma
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Combined neutrophil/platelet/lymphocyte/differentiation score predicts chemosensitivity in advanced gastric cancer
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Efficacy and Toxicity of Mammalian Target Rapamycin Inhibitors in Patients with Metastatic Renal Cell Carcinoma with Renal Insufficiency: The Korean Cancer Study Group GU 14-08: Ki Hyang Kim, Joo Hoon Kim, Ji Young Lee, Hyo Song Kim, Su Jin Heo, Ji Hyung Kim, Ho Young Kim, Sun Young Rha; Cancer Res Treat. 2016;48(4):1286-1292. Published online February 12, 2016; DOI: https://doi.org/10.4143/crt.2016.018

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Purpose
We evaluated the efficacy and toxicity of mammalian target rapamycin inhibitors in Korean patients with metastatic renal cell carcinoma (mRCC) with chronic renal insufficiency not requiring dialysis. Materials and Methods Korean patients with mRCC and chronic renal insufficiency not requiring dialysis treated with everolimus or temsirolimus between January 2008 and December 2014 were included. Patient characteristics, clinical outcomes, and toxicities were evaluated. Overall survival (OS) and progression-free survival (PFS) durations were evaluated according to the degree of renal impairment.
Results
Eighteen patients were considered eligible for the study (median age, 59 years). The median glomerular filtration rate was 51.5 mL/min/1.73 m2. The best response was partial response in six patients and stable disease in 11 patients. The median PFS and OS durations were 8 months (95% confidence interval [CI], 0 to 20.4) and 32 months (95% CI, 27.5 to 36.5), respectively. The most common non-hematologic and grade 3/4 adverse events included stomatitis, fatigue, flu-like symptoms, and anorexia as well as elevated creatinine level. Conclusion Mammalian target rapamycin inhibitors were efficacious and did not increase toxicity in Korean patients with mRCC and chronic renal insufficiency not requiring dialysis.

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Prevalence of acute oral mucosal damage secondary to the use of systemic antineoplastics: A systematic review and meta-analysis
Manuel Eros Rodríguez-Fuentes, Mario Pérez-Sayáns, Carmen Martín Carreras-Presas, Xabier Marichalar-Mendia, Leticia Bagán-Debón, Rafael López-López
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2023; 135(3): 385. CrossRef
Renal toxicity of targeted therapies for renal cell carcinoma in patients with normal and impaired kidney function
Łukasz Mielczarek, Anna Brodziak, Paweł Sobczuk, Maciej Kawecki, Agnieszka Cudnoch-Jędrzejewska, Anna M. Czarnecka
Cancer Chemotherapy and Pharmacology.2021; 87(6): 723. CrossRef
Safety and Efficacy of Pazopanib in First-Line Metastatic Renal-Cell Carcinoma With or Without Renal Failure: CORE-URO-01 Study
Cristina Masini, Maria Giuseppa Vitale, Marco Maruzzo, Giuseppe Procopio, Ugo de Giorgi, Sebastiano Buti, Sabrina Rossetti, Roberto Iacovelli, Francesco Atzori, Laura Cosmai, Francesca Vignani, Giuseppe Prati, Sarah Scagliarini, Annalisa Guida, Annalisa B
Clinical Genitourinary Cancer.2019; 17(1): e150. CrossRef
Renal toxicity with mammalian target of rapamycin inhibitors: A meta-analysis of randomized clinical trials
Ravi K. Paluri, Guru Sonpavde, Charity Morgan, Jacob Rojymon, Anastasia Hartzes Mar, Radhika Gangaraju
Oncology Reviews.2019;[Epub] CrossRef

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Is there a "Trial Effect" on Outcome of Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib?: Daniel Keizman, Keren Rouvinov, Avishay Sella, Maya Gottfried, Natalie Maimon, Jenny J. Kim, Mario A. Eisenberger, Victoria Sinibaldi, Avivit Peer, Michael A. Carducci, Wilmosh Mermershtain, Raya Leibowitz-amit, Rony Weitzen, Raanan Berger; Cancer Res Treat. 2016;48(1):281-287. Published online March 5, 2015; DOI: https://doi.org/10.4143/crt.2014.289

Abstract PDF PubReader ePub

Purpose
Studies suggested the existence of a ‘trial effect', in which for a given treatment, participation in a clinical trial is associated with a better outcome. Sunitinib is a standard treatment for metastatic renal cell carcinoma (mRCC). We aimed to study the effect of clinical trial participation on the outcome of mRCC patients treated with sunitinib, which at present, is poorly defined.
Materials and Methods
The records of mRCC patients treated with sunitinib between 2004-2013 in 7 centers across 2 countries were reviewed. We compared the response rate (RR), progression free survival (PFS), and overall survival (OS), between clinical trial participants (n=49) and a matched cohort of non-participants (n=49) who received standard therapy. Each clinical trial participant was individually matched with a non participant by clinicopathologic factors. PFS and OS were determined by Cox regression.
Results
The groups were matched by age (median 64), gender (male 67%), Heng risk (favorable 25%, intermediate 59%, poor 16%), prior nephrectomy (92%), RCC histology (clear cell 86%), pre-treatment NLR (>3 in 55%, n=27), sunitinib induced hypertension (45%), and sunitinib dose reduction/treatment interruption (41%). In clinical trial participants versus non-participants, RR was partial response/stable disease 80% (n=39) versus 74% (n=36), and progressive disease 20% (n=10) versus 26% (n=13) (p=0.63, OR 1.2). The median PFS was 10 versus 11 months (HR=0.96, p=0.84), and the median OS 23 versus 24 months (HR=0.97, p=0.89).
Conclusions
In mRCC patients treated with sunitinib, the outcome of clinical trial participants was similar to that of non-participants who received standard therapy.

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Clinical characteristics and outcomes of patients enrolled in clinical trials compared with those of patients outside clinical trials in advanced gastric cancer
Jae Joon Han, Jin Won Kim, Koung Jin Suh, Ji‐won Kim, Se Hyun Kim, Yu Jung Kim, Jee Hyun Kim, Jong Seok Lee, Keun‐Wook Lee
Asia-Pacific Journal of Clinical Oncology.2019; 15(3): 158. CrossRef
Participants in a randomized controlled trial had longer overall survival than non-participants: a prospective cohort study
Shinji Ohno, Hirofumi Mukai, Kazutaka Narui, Yasuo Hozumi, Yasuo Miyoshi, Hiroshi Yoshino, Hiroyoshi Doihara, Akihiko Suto, Motoshi Tamura, Takashi Morimoto, Hisamitsu Zaha, Takashi Chishima, Reiki Nishimura, Takashi Ishikawa, Yukari Uemura, Yasuo Ohashi
Breast Cancer Research and Treatment.2019; 176(3): 631. CrossRef
Long-term response to sunitinib: everolimus treatment in metastatic clear cell renal cell carcinoma
Anna M Czarnecka, Paweł Sobczuk, Jan Korniluk, Marta Spychalska, Krzysztof Bogusz, Anna Owczarek, Anna Brodziak, Dominika Labochka, Barbara Moszczuk, Cezary Szczylik
Future Oncology.2017; 13(1): 31. CrossRef
Assessment of ethnic differences in sunitinib outcome between Caucasian and Asian patients with metastatic renal cell carcinoma: a meta-analysis
Xiaoyan Liu, Marta Fiocco, Jesse J. Swen, Henk-Jan Guchelaar
Acta Oncologica.2017; 56(4): 582. CrossRef
Eligibility for phase 3 clinical trials of systemic therapy in real-world patients with metastatic renal cell cancer managed in a rural region
Carsten Nieder, Mohsan A. Syed, Astrid Dalhaug, Adam Pawinski, Jan Norum
Medical Oncology.2017;[Epub] CrossRef
Overexpression of the YAP1 oncogene in clear cell renal cell carcinoma is associated with poor outcome
Agnieszka Rybarczyk, Jakub Klacz, Agata Wronska, Marcin Matuszewski, Zbigniew Kmiec, Piotr M. Wierzbicki
Oncology Reports.2017; 38(1): 427. CrossRef

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Case Report

A Case of von Hippel–Lindau Disease with Colorectal Adenocarcinoma, Renal Cell Carcinoma and Hemangioblastomas: Su Jin Heo, Choong-kun Lee, Kyu Yeon Hahn, Gyuri Kim, Hyuk Hur, Sung Hoon Choi, Kyung Seok Han, Arthur Cho, Minkyu Jung; Cancer Res Treat. 2016;48(1):409-414. Published online February 17, 2015; DOI: https://doi.org/10.4143/crt.2014.299

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von Hippel–Lindau (VHL) disease is an autosomal dominant inherited tumor syndrome associated with mutations of the VHL tumor suppressor gene located on chromosome 3p25. The loss of functional VHL protein contributes to tumorigenesis. This condition is characterized by development of benign and malignant tumors in the central nervous system (CNS) and the internal organs, including kidney, adrenal gland, and pancreas. We herein describe the case of a 74-year-old man carrying the VHL gene mutation who was affected by simultaneous colorectal adenocarcinoma, renal clear cell carcinoma, and hemangioblastomas of CNS.

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Diversities of Mechanism in Patients with VHL Syndrome and diabetes: A Report of Two Cases and Literature Review
Yanlei Wang, Zhaoxiang Liu, Wenhui Zhao, Chenxiang Cao, Luqi Xiao, Jianzhong Xiao
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 1611. CrossRef
Sporadic Renal Hemangioblastoma: A Case Report of a Rare Entity
Fnu Raja, Vinesh Kumar, Azzam Hammad, Caroline Abramovich
Cureus.2023;[Epub] CrossRef
VHL syndrome without clear family history: A rare case report and literature review of Chinese patients
Yaheng Li, Xiaohong Xin, Wenzhu Song, Xuan Zhang, Shengli Chen, Qian Wang, Aizhong Li, Yafeng Li
Frontiers in Neurology.2022;[Epub] CrossRef
Von Hipple-Lindau disease complicated with central retinal vein occlusion: a case report
Xingwang Chen, Mengyao Wang, Yuan Tang, Bing Xie, Xiaomei Nie, Shanjun Cai
BMC Ophthalmology.2022;[Epub] CrossRef
Whole-Exome Sequencing Reveals Novel Variations in Patients with Familial Von Hippel−Lindau Syndrome
Yuhao Zhou, Jian Liu, Liangzhao Chu, Minghao Dong, Luqian Feng
World Neurosurgery.2021; 150: e696. CrossRef
Sporadic renal hemangioblastoma: A case report of a rare benign renal tumor
Lukas Oberhammer, Michael Josef Mitterberger, Lukas Lusuardi, Thomas Kunit, Martin Drerup, Daniela Colleselli, Hubert Griessner, Martina Hager
Clinical Case Reports.2019; 7(12): 2321. CrossRef
MicroRNA Assisted Gene Regulation in Colorectal Cancer
Adewale Fadaka, Ashley Pretorius, Ashwil Klein
International Journal of Molecular Sciences.2019; 20(19): 4899. CrossRef

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Original Articles

Which Patients Should We Follow up beyond 5 Years after Definitive Therapy for Localized Renal Cell Carcinoma?: Sang Hyub Lee, Hee Seo Son, Seok Cho, Sang Jin Kim, Dae Seon Yoo, Seok Ho Kang, Sung Yul Park, Jinsung Park, Sung-Goo Chang, Seung Hyun Jeon; Cancer Res Treat. 2015;47(3):489-494. Published online November 17, 2014; DOI: https://doi.org/10.4143/crt.2014.013

Abstract PDF PubReader ePub

Purpose
Up to 10% of recurrences develop beyond 5 years after curative treatment of localized renal cell carcinoma (RCC). Clinicopathologic features were evaluated to determine which factors are associated with late recurrence.
Materials and Methods
A total of 753 patients were diagnosed with localized RCC from January 2000 to June 2008. We enrolled 225 patients who were treated surgically and had a minimal recurrence-free survival of 60 months. Patients who had recurrence beyond 5 years after nephrectomy were defined as the late recurrence group and the remaining patients as the recurrence-free group. Multivariate logistic regression analyses and the Cox proportional hazard model were used for determination of features associated with late recurrence.
Results
In multivariate analyses, age older than 60 (p=0.030), Fuhrman grade ≥ 3 (p=0.042), and pT stage ≥ pT2 (p=0.010) showed statistical association with late recurrence. The Cox proportional hazard model showed significant differences in recurrence-free survival when we classified the patients based on pT2 (p=0.007) and on patient age ≥ 60 years (p=0.039).
Conclusion
Patient age greater than 60 years, Fuhrman grade ≥ 3, and tumor stage ≥ pT2 are independent risk factors of recurrence more than 5 years after surgery in patients with RCC. Therefore, close lifelong follow-up is recommended for patients with these risk factors.

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Comparison of the Efficacy of Percutaneous Microwave Ablation Therapy versus Laparoscopic Partial Nephrectomy for Early-Stage Renal Tumors
Osman Kula, Yeliz Ateş, Hakkı Mete Çek, Atınç Tozsin, Burak Günay, Burak Akgül, Selçuk Korkmaz, Gökhan Karataş, Serdar Solak, Fethi Emre Ustabaşıoğlu, Ersan Arda
Diagnostics.2024; 14(14): 1574. CrossRef
Machine Learning Approach to Predict the Probability of Recurrence of Renal Cell Carcinoma After Surgery: Prediction Model Development Study
HyungMin Kim, Sun Jung Lee, So Jin Park, In Young Choi, Sung-Hoo Hong
JMIR Medical Informatics.2021; 9(3): e25635. CrossRef
Risk‐adjusted proposal for >60 months follow up after surgical treatment of organ‐confined renal cell carcinoma according to life expectancy
Sebastian K Frees, Mohammed M Kamal, Sebastian Nestler, Patrick MF Levien, Samir Bidnur, Walburgis Brenner, Christian Thomas, Wolfgang Jaeger, Joachim W Thüroff, Frederik C Roos
International Journal of Urology.2019; 26(3): 385. CrossRef
Partial nephrectomy versus ablative techniques for small renal masses: a systematic review and network meta-analysis
Johannes Uhlig, Arne Strauss, Gerta Rücker, Ali Seif Amir Hosseini, Joachim Lotz, Lutz Trojan, Hyun S. Kim, Annemarie Uhlig
European Radiology.2019; 29(3): 1293. CrossRef

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Clinical Features and Treatment of Collecting Duct Carcinoma of the Kidney from the Korean Cancer Study Group Genitourinary and Gynecology Cancer Committee: Kyung A Kwon, Sung Yong Oh, Ho Young Kim, Hyo Song Kim, Ha Young Lee, Tae Min Kim, Ho Yeong Lim, Na-Ri Lee, Hyo Jin Lee, Sook Hee Hong, Sun Young Rha; Cancer Res Treat. 2014;46(2):141-147. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.141

Abstract PDF PubReader ePub

Purpose

Collecting duct carcinoma (CDC) of the kidney is an aggressive disease with a poor prognosis, accountings for less than 1% of all renal cancers. To date, no standard therapy for CDC has been established. The aim of this study is an investigation of clinicopathologic findings of CDC and correlation of the disease status with a prognosis.

Materials and Methods

From 1996 to 2009, 35 patients with CDC were treated at eight medical centers. The diagnosis of CDC was made based on nephrectomy in 27 cases and renal biopsy in eight cases.

Results

Median PFS and OS for all patients were 5.8 months (95% CI 3.5 to 9.2) and 54.4 months (95% CI 0 to 109.2), respectively. The OS of patients with Stages I-III was 69.9 months (95% CI 54.0 to 85.8), while that of patients with Stage IV was 8.6 months (95% CI 0 to 23.3), which showed a statistically significant difference (p=0.01). In addition, among patients with Stage IV, the OS of patients who received a palliative treatment (immunotherapy, chemotherapy, or targeted therapy) was 18.4 months, which was higher than the OS of patients without treatment of 4.5 months.

Conclusion

CDC is a highly aggressive form of renal cell carcinoma. Despite most of the treatments, PFS and OS were short, however, there were some long-term survivors, therefore, conduct of additional research on the predictive markers of the several clinical, pathological differences and their treatments will be necessary.

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Sang Bin Bae, Seong Kuk Yoon, Seo-hee Rha
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Zoé Guillaume, Emeline Colomba, Jonathan Thouvenin, Carolina Saldana, Luca Campedel, Clément Dumont, Brigitte Laguerre, Denis Maillet, Cécile Vicier, Frédéric Rolland, Delphine Borchiellini, Philippe Barthelemy, Laurence Albiges, Edouard Auclin, Matthieu
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Benjamin Laguna, Antonio C. Westphalen, C. T. Guimarães, Zhen Whang, Jeff Simko, Ronald Zagoria
Abdominal Radiology.2019; 44(4): 1430. CrossRef
Collecting Duct Carcinoma of the Kidney: Analysis of Our Experience at the SPANISH ‘Grupo Centro’ of Genitourinary Tumors
A. Pinto, M. Garrido, C. Aguado, T. Alonso, P. Gajate, C. Maximiano, I. García-Carbonero, A. Martín, I. Gallegos, J.A. Arranz, J. Puente, E. Grande
Kidney Cancer.2019; 3(3): 177. CrossRef
Non-Clear Cell Renal Cell Carcinoma: Current Management and Best Practice
Meghan Salgia, Jacob Adashek, Paulo Bergerot, Sumanta K. Pal
Kidney Cancer.2017; 1(2): 99. CrossRef
Unique Transcriptomic Profile of Collecting Duct Carcinomas Relative to Upper Tract Urothelial Carcinomas and other Kidney Carcinomas
Gabriel G. Malouf, Eva Compérat, Hui Yao, Roger Mouawad, Veronique Lindner, Nathalie Rioux-leclercq, Virginie Verkarre, Xavier Leroy, Linda Dainese, Marion Classe, Jean-Luc Descotes, Philippe Barthelemy, Mokrane Yacoub, Morgan Rouprêt, Jean-Christophe Ber
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ZHENSHAN SHI, QIAN ZHUANG, RUIXIONG YOU, YUEMING LI, JIAN LI, DAIRONG CAO
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Collecting duct carcinoma of the kidney is associated withCDKN2Adeletion andSLCfamily gene up-regulation
Jianmin Wang, Antonios Papanicolau-Sengos, Sreenivasulu Chintala, Lei Wei, Biao Liu, Qiang Hu, Kiersten Marie Miles, Jeffrey M. Conroy, Sean T. Glenn, Manuela Costantini, Cristina Magi-Galluzzi, Sabina Signoretti, Toni Choueiri, Michele Gallucci, Steno Se
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Case Reports

Sunitinib Treatment for Metastatic Renal Cell Carcinoma in Patients with Von Hippel-Lindau Disease: Ho Cheol Kim, Jung Su Lee, Sang Hyung Kim, Hoon Sub So, Chang Yoon Woo, Jae Lyun Lee; Cancer Res Treat. 2013;45(4):349-353. Published online December 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.4.349

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Von Hippel-Lindau (VHL) disease is an autosomal dominant disease that produces a variety of tumors and cysts in the central nervous system and visceral organs, including renal cell carcinoma (RCC). RCC in patients with VHL disease does not frequently metastasize, therefore, the response to treatment and prognosis of metastatic RCC developed in patients with VHL disease has not been reported. Sunitinib is an oral, multitargeted receptor tyrosine kinase inhibitor with antiangiogenic and antitumor activity. Here, we report on four patients with metastatic RCC in VHL disease who received sunitinib and achieved partial responses that have lasted for a prolonged period of time.

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Hereditary renal cell tumors: Clinicopathologic importance
Harmanjot Singh, Mukul K. Divatia, Donghwa Baek, Jae Y. Ro
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Von Hippel-Lindau Disease: Current Challenges and Future Prospects

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The Efficacy and Safety of Tyrosine Kinase Inhibitors for Von Hippel–Lindau Disease: A Retrospective Study of 32 Patients
Kaifang Ma, Baoan Hong, Jingcheng Zhou, Yanqing Gong, Jiangyi Wang, Shengjie Liu, Xiang Peng, Bowen Zhou, Jiufeng Zhang, Haibiao Xie, Kenan Zhang, Lei Li, Desheng Cai, Zixin Wang, Lin Cai, Kan Gong
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A retrospective case study of sunitinib treatment in three patients with Von Hippel-Lindau disease
Gang Yuan, Qiuli Liu, Dali Tong, Gaolei Liu, Yuting Yi, Jun Zhang, Yao Zhang, Lin-ang Wang, Luofu Wang, Rongrong Chen, Yanfang Guan, Xin Yi, Weihua Lan, Jun Jiang
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A Case of von Hippel–Lindau Disease with Colorectal Adenocarcinoma, Renal Cell Carcinoma and Hemangioblastomas
Su Jin Heo, Choong-kun Lee, Kyu Yeon Hahn, Gyuri Kim, Hyuk Hur, Sung Hoon Choi, Kyung Seok Han, Arthur Cho, Minkyu Jung
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Attainment of a Long-term Favorable Outcome by Sunitinib Treatment for Pancreatic Neuroendocrine Tumor and Renal Cell Carcinoma Associated with von Hippel-Lindau Disease
Akihiro Kobayashi, Masanobu Takahashi, Hiroo Imai, Shoko Akiyama, Shunsuke Sugiyama, Keigo Komine, Ken Saijo, Masahiro Takahashi, Shin Takahashi, Hidekazu Shirota, Naomi Sato, Fumiyoshi Fujishima, Taro Shuin, Hideki Shimodaira, Chikashi Ishioka
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Sunitinib for the treatment of benign and malignant neoplasms from von Hippel-Lindau disease: A single-arm, prospective phase II clinical study from the PREDIR group
Stéphane Oudard, Reza Elaidi, Mara Brizard, Céline Le Rest, Valérie Caillet, Sophie Deveaux, Gérard Benoit, Jean-Michel Corréas, Farida Benoudiba, Philippe David, Alain Gaudric, Pascal Hammel, Dominique Joly, Marc Olivier Timsit, Arnaud Méjean, Stéphane R
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Metastatic Renal Cell Carcinoma in a Supraclavicular Lymph Node with No Known Primary: A Case Report: Young-Rak Choi, Hye-Suk Han, Ok-Jun Lee, Sung-Nam Lim, Mi-Jin Kim, Myeong-Ho Yeon, Hyun-Jung Jeon, Ki Hyeong Lee, Seung Taik Kim; Cancer Res Treat. 2012;44(3):215-218. Published online September 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.3.215

Abstract PDF PubReader ePub

Although metastasis is relatively frequent in cases of renal cell carcinoma (RCC), metastasis in the cervical or supraclavicular lymph node (LN) is relatively rare. Moreover, cases of metastatic RCC with a non-identifiable kidney mass are extremely rare. Here, the authors report a case of metastatic RCC in a supraclavicular LN without a primary kidney lesion. A 69-year-old man presented with a progressively enlarging right supraclavicular mass. Incisional biopsy of the affected supraclavicular LN was performed, and histological examination revealed metastatic RCC. However, no tumor was found in either kidney, despite various examinations. The patient was treated with radiotherapy followed by sunitinib. After three months on sunitinib, a follow-up computed tomography scan revealed that the supraclavicular LN had markedly decreased, and after 20 months, the disease had not progressed. This case suggests that, even when there is no primary kidney lesion, clinicians must consider the possibility of metastatic RCC when evaluating patients with clear cell carcinoma with an unknown primary site.

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Novel Sunitinib Strategy in Metastatic Renal Cell Carcinoma on Hemodialysis: Intermittent Dose of Sunitinib after Hemodialysis: Sang Hyun Yoon, Ki Hyang Kim, Junjeong Choi, Gun Min Kim, Joo Hoon Kim, Hyo Song Kim, Young Nyun Park, Sun Young Rha; Cancer Res Treat. 2010;42(3):180-184. Published online September 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.3.180

Abstract PDF PubReader ePub

The proper dose and schedule of sunitinib have yet to be established for patients with metastatic renal cell carcinoma (RCC) on hemodialysis. We reviewed two patients with metastatic RCC on hemodialysis who had been treated with sunitinib in Yonsei Cancer Center, Yonsei University College of Medicine. Fifty milligrams of sunitinib was administered intermittently after each hemodialysis session (3 or 4 times a week). Overall responses were partial response in both cases. Progression-free survivals were 16 and 6 months, respectively, at the time of reporting (April 2010). Both subjects tolerated the treatment.

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Targeted and immune therapies among patients with metastatic renal carcinoma undergoing hemodialysis: A systemic review
Elodie Klajer, Louis Garnier, Morgan Goujon, Friederike Schlurmann-Constans, Benoite Mery, Thierry Nguyen Tan Hon, Guillaume Mouillet, Fabien Calcagno, Antoine Thiery-Vuillemin
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Targeted Agents in Patients with Metastatic Renal Cell Carcinoma on Dialysis: Myths and Reality
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Recent Aspects of Sunitinib Therapy in Patients with Metastatic Clear-Cell Renal Cell Carcinoma: a Systematic Review of the Literature
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Original Articles

Treatment Outcomes of Sunitinib Treatment in Advanced Renal Cell Carcinoma Patients: A Single Cancer Center Experience in Korea: Min Hee Hong, Hyo Song Kim, Chan Kim, Jung Ryun Ahn, Hong Jae Chon, Sang-Joon Shin, Joong-Bae Ahn, Hyun Cheol Chung, Sun Young Rha; Cancer Res Treat. 2009;41(2):67-72. Published online June 30, 2009; DOI: https://doi.org/10.4143/crt.2009.41.2.67

Abstract PDF PubReader ePub

Purpose

The retrospective study was performed to assess the efficacy and toxicity profiles of sunitinib in Korean patients with metastatic renal cell carcinoma (RCC).

Materials and Methods

Between January 2005 and December 2008, 76 Korean patients with recurrent/metastatic RCC who received sunitinib were retrospectively reviewed. The primary end point was progression-free survival and the secondary end points were overall survival and response rate. We also assessed the toxicities associated with sunitinib treatment.

Results

Of the 76 patients, 69 (90.1%) were diagnosed with clear cell RCC. The median progression-free survival and overall survival were 7.2 and 22.8 months, respectively in overall patients. Sixty-two patients (81.6%) received 50 mg 4 week and 2 week off schedule, and 14 patients (18.4%) received 37.5 mg daily on a daily continuous schedule. The objective response rate and disease control rate were 27.6% and 84.2%, respectively. A dose reduction or reduction in dose due to adverse events occurred in 76% of the patients, whereas 11% of the patients had discontinued treatment. Other common laboratory abnormalities were increased serum creatinine (75.6%), elevated alanine aminotransferase (71.0%), neutropenia (61.8%), anemia (69.7%), and increased aspartate aminotrasferase (53.3%). Grade 3/4 toxicities occurred as follows: thrombocytopenia (38.2%), fatigue (10.5%), stomatitis (10.5%), and hand-foot syndrome (9.2%).

Conclusion

Our results indicate that sunitinib treatment is effective and tolerable for ecurrent/metastatic RCC patients in Korea. Further studies with prognostic or biochemical factors are needed to clarify the different toxicity profiles of this study.

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Cancer Chemotherapy and Pharmacology.2013; 72(4): 825. CrossRef
Validation of the MSKCC and Heng Risk Criteria Models for Predicting Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib
Whi-An Kwon, In-Chang Cho, Ami Yu, Byung-Ho Nam, Jae Young Joung, Ho Kyung Seo, Kang Hyun Lee, Jinsoo Chung
Annals of Surgical Oncology.2013; 20(13): 4397. CrossRef
Efficacy and safety of everolimus in Korean patients with metastatic renal cell carcinoma
Ki Hyang Kim, Sang Hyun Yoon, Hae-Jung Lee, Hyo Song Kim, Sang Joon Shin, Joong Bae Ahn, Sun Young Rha
Cancer Chemotherapy and Pharmacology.2013; 72(4): 853. CrossRef
Safety and treatment patterns of angiogenesis inhibitors in patients with advanced renal cell carcinoma in Spain
Daniel Castellano, Mei Sheng Duh, Caroline Korves, Ellison Dial Suthoff, Maureen Neary, Luis Javier Hernández Pastor, Joaquim Bellmunt
Expert Opinion on Drug Safety.2013; 12(4): 455. CrossRef
Phase I study of the safety, pharmacokinetics and antitumor activity of famitinib
Aiping Zhou, Wen Zhang, Chunxiao Chang, Xiaoyan Chen, Dafang Zhong, Qiong Qin, Donghua Lou, Haoyuan Jiang, Jinwan Wang
Cancer Chemotherapy and Pharmacology.2013; 72(5): 1043. CrossRef
Analysis of the Reasons for Dose Reduction or Discontinuation of Sunitinib in Korean Patients
노지혜, 이주연, 이혜숙, 김향숙, 강래영, 이용화
Journal of Korean Society of Health-System Pharmacists.2013; 30(3): 210. CrossRef
Effect of P-Glycoprotein and Breast Cancer Resistance Protein Inhibition on the Pharmacokinetics of Sunitinib in Rats
Sachiko Kunimatsu, Tomoyuki Mizuno, Masahide Fukudo, Toshiya Katsura
Drug Metabolism and Disposition.2013; 41(8): 1592. CrossRef
Famitinib in metastatic renal cell carcinoma: a single center study
Wen ZHANG, Ai-Ping ZHOU, Qiong QIN, Chun-Xiao CHANG, Hao-Yuan JIANG, Jian-Hui MA, Jin-Wan WANG
Chinese Medical Journal.2013; 126(22): 4277. CrossRef
Management of sunitinib adverse events in renal cell carcinoma patients: The Asian experience
Aiping ZHOU
Asia-Pacific Journal of Clinical Oncology.2012; 8(2): 132. CrossRef
Sunitinib as a second-line therapy for advanced GISTs after failure of imatinib: relationship between efficacy and tumor genotype in Korean patients
Dok Hyun Yoon, Min-Hee Ryu, Baek-Yeol Ryoo, Moyeol Beck, Dae Ro Choi, Yoojin Cho, Jae-Lyun Lee, Heung-Moon Chang, Tae Won Kim, Yoon-Koo Kang
Investigational New Drugs.2012; 30(2): 819. CrossRef
Current Status of Targeted Therapy for Advanced Renal Cell Carcinoma
In-Chang Cho, Jinsoo Chung
Korean Journal of Urology.2012; 53(4): 217. CrossRef
Impact of Genetic Variation in Breast Cancer Resistance Protein (BCRP/ABCG2) on Sunitinib Pharmacokinetics
Tomoyuki Mizuno, Masahide Fukudo, Tomohiro Terada, Tomomi Kamba, Eijiro Nakamura, Osamu Ogawa, Ken-ichi Inui, Toshiya Katsura
Drug Metabolism and Pharmacokinetics.2012; 27(6): 631. CrossRef
Response Rates and Adverse Effects of Continuous Once-daily Sunitinib in Patients with Advanced Renal Cell Carcinoma: A Single-center Study in Turkey
I. Yildiz, F. Sen, M. Basaran, M. Ekenel, F. Agaoglu, E. Darendeliler, H. M. Tunc, F. Ozcan, S. Bavbek
Japanese Journal of Clinical Oncology.2011; 41(12): 1380. CrossRef
Key predictive factors of axitinib (AG-013736)-induced proteinuria and efficacy: A phase II study in Japanese patients with cytokine-refractory metastatic renal cell Carcinoma
Yoshihiko Tomita, Hirotsugu Uemura, Hiroyuki Fujimoto, Hiro-omi Kanayama, Nobuo Shinohara, Hayakazu Nakazawa, Keiji Imai, Yoshiko Umeyama, Seiichiro Ozono, Seiji Naito, Hideyuki Akaza
European Journal of Cancer.2011; 47(17): 2592. CrossRef
Efficacy and Safety of Sunitinib on Metastatic Renal Cell Carcinoma: A Single-Institution Experience
Eugene Hwang, Hyo Jin Lee, Chong Koo Sul, Jae Sung Lim
Korean Journal of Urology.2010; 51(7): 450. CrossRef
Kidney Cancer Working Group Report
S. Naito, Y. Tomita, S. Y. Rha, H. Uemura, M. Oya, H. Z. Song, L. H. Zhong, M. I. B. A. Wahid
Japanese Journal of Clinical Oncology.2010; 40(Supplement): i51. CrossRef
Hematologic Toxicity in Patients Treated with Sunitinib for Advanced Thyroid Cancer
Anastasios Gkountouvas, Ifigeneia Kostoglou-Athanassiou, Eirini Veniou, Panagiotis Repousis, Nikolaos Ziras, Philippos Kaldrimidis
Thyroid.2010; 20(6): 597. CrossRef
The Efficacy and Safety of Sunitinib in Korean Patients with Advanced Renal Cell Carcinoma: High Incidence of Toxicity Leads to Frequent Dose Reduction
C. Yoo, J. E. Kim, J.-L. Lee, J.-H. Ahn, D. H. Lee, J.-S. Lee, S. Na, C.-S. Kim, J. H. Hong, B. Hong, C. Song, H. Ahn
Japanese Journal of Clinical Oncology.2010; 40(10): 980. CrossRef
Novel Sunitinib Strategy in Metastatic Renal Cell Carcinoma on Hemodialysis: Intermittent Dose of Sunitinib after Hemodialysis
Sang Hyun Yoon, Ki Hyang Kim, Junjeong Choi, Gun Min Kim, Joo Hoon Kim, Hyo Song Kim, Young Nyun Park, Sun Young Rha
Cancer Research and Treatment.2010; 42(3): 180. CrossRef
Comparative Analysis between Immunochemotherapy and Target Therapy for Metastatic Renal Cell Carcinoma: Overview of Treatment-Related Adverse Events and the Dropout Rate in Korea
Jee Han Lee, Sung-Goo Chang, Seung Hyun Jeon, Gyeong Eun Min, Koo Han Yoo
Korean Journal of Urology.2010; 51(6): 379. CrossRef

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A Matched-cohort Comparison of Laparoscopic Renal Cryoablation using Ultra-thin Cryoprobes with Open Partial Nephrectomy for the Treatment of Small Renal Cell Carcinoma: Young Hwii Ko, Hong Seok Park, Du Geon Moon, Jeong Gu Lee, Je Jong Kim, Duck Ki Yoon, Seok Ho Kang, Jun Cheon; Cancer Res Treat. 2008;40(4):184-189. Published online December 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.4.184

Abstract PDF PubReader ePub

Purpose

To evaluate the feasibility and efficacy of performing laparoscopic renal cryoablation (LRC) for the treatment of RCC, as compared with open partial nephrectomy (OPN), which is the established NSS.

Materials and Methods

From April 2004, among the patients who underwent LRC with a 1.47 mm cryoprobe, we enrolled 20 patients who were pathologically confirmed as having RCC with a tumor size smaller than 4 cm. These patients were matched with a group of 20 patients, who were selected based on the pre-operative characteristics of the tumor and those of the patients, from a pre-existing database of the patients who underwent OPN during the same period.

Results

The mean age and tumor size were 56.3±11.5 years and 2.4±1.7 cm in the LRC group, and 57.6±10.9 years and 2.2±1.1 cm in the OPN group. The two groups were similar for their age, gender, BMI, ASA, the tumor characteristics and the indications for operation. While the pathologic results and the operation time showed similarity, the EBL (98±87 ml vs 351±147 ml, respectively, p=0.001), the transfusion rate (10% vs 40%, respectively, p=0.03) and the hospital stay (4.2±1.5 days vs 8.2±2.4 days, respectively, p=0.005) were significantly less in the LRC group. Major complications did not occur in the LRC group, but in the OPN group, one patient experienced urine leakage and one patient had a perirenal hematoma. During the mean follow up of 27.3±10.8 months and 28.7±14.9 months for each group, respectively, all the patients remained disease-free with no evidence of local recurrence or metastases.

Conclusions

LRC using ultra-thin cryoprobes for the treatment of small RCC showed similar effective oncologic results with the merits of minimal invasiveness, as compared with OPN, during the intermediate term follow up.

Citations

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Stage IA papillary and chromophobe renal cell carcinoma: effectiveness of cryoablation and partial nephrectomy
Annemarie Uhlig, Johannes Uhlig, Brian Shuch, Hyun S. Kim
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Takafumi Yanagisawa, Keiichiro Mori, Tatsushi Kawada, Reza Sari Motlagh, Hadi Mostafaei, Fahad Quhal, Ekaterina Laukhtina, Pawel Rajwa, Abdulmajeed Aydh, Frederik König, Maximilian Pallauf, Benjamin Pradere, Jun Miki, Takahiro Kimura, Shin Egawa, Shahrokh
Urologic Oncology: Seminars and Original Investigations.2022; 40(7): 315. CrossRef
Partial nephrectomy vs cryoablation for T1a renal cell carcinoma: A comparison of survival benefit stratified by tumour size
Xinyang Liao, Shi Qiu, Wanyu Wang, Xiaonan Zheng, Kun Jin, Shiyu Zhang, Yige Bao, Lu Yang, Qiang Wei
Cancer Epidemiology.2019; 59: 221. CrossRef
Partial nephrectomy versus ablative therapies for cT1a renal masses: A Systematic Review and meta-analysis
Xu Hu, Yan-Xiang Shao, Yan Wang, Zhi-Qiang Yang, Wei-Xiao Yang, Xiang Li
European Journal of Surgical Oncology.2019; 45(9): 1527. CrossRef
Comparison among cryoablation, radiofrequency ablation, and partial nephrectomy for renal cell carcinomas sized smaller than 2 cm or sized 2–4 cm
Shuai Yan, Wei Yang, Cheng-mei Zhu, Pei-meng Yan, Zhi-chao Wang
Medicine.2019; 98(21): e15610. CrossRef
Ablative Therapy for Small Renal Masses
Benjamin L. Taylor, S. William Stavropoulos, Thomas J. Guzzo
Urologic Clinics of North America.2017; 44(2): 223. CrossRef
A national study of kidney graft tumor treatments: Toward ablative therapy
Kerem Guleryuz, Arnaud Doerfler, Ricardo Codas, Grégoire Coffin, Jacques Hubert, Eric Lechevallier, Xavier Tillou, L. Badet, B. Barrou, T. Bessede, P. Blanchet, J.M. Boutin, J. Branchereau, T. Culty, V. Delaporte, F. Gaudez, M. Gigante, G. Karam, F. Klein
Surgery.2016; 160(1): 237. CrossRef
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William Quiroga Matamoros, Fernando Fernandez, Danilo Citarella Otero, Jaime Rangel, Andrea Estrada Guerrero, Iván Darío Patiño
Urología Colombiana.2016; 25(2): 169. CrossRef
Current Status of Cryotherapy for Prostate and Kidney Cancer
Seok Cho, Seok Ho Kang
Korean Journal of Urology.2014; 55(12): 780. CrossRef
Retrospective Comparison of Laparoscopic Partial Nephrectomy Versus Laparoscopic Renal Cryoablation for Small (<3.5 cm) Cortical Renal Masses
Georgios Haramis, Joseph A. Graversen, Adam C. Mues, Ruslan Korets, Juan Carlos Rosales, Zhamshid Okhunov, Ketan K. Badani, Mantu Gupta, Jaime Landman
Journal of Laparoendoscopic & Advanced Surgical Techniques.2012; 22(2): 152. CrossRef
Systematic Review of Perioperative and Quality-of-life Outcomes Following Surgical Management of Localised Renal Cancer
Steven MacLennan, Mari Imamura, Marie C. Lapitan, Muhammad Imran Omar, Thomas B.L. Lam, Ana M. Hilvano-Cabungcal, Pam Royle, Fiona Stewart, Graeme MacLennan, Sara J. MacLennan, Philipp Dahm, Steven E. Canfield, Sam McClinton, T.R. Leyshon Griffiths, Börje
European Urology.2012; 62(6): 1097. CrossRef
Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer
Steven MacLennan, Mari Imamura, Marie C. Lapitan, Muhammad Imran Omar, Thomas B.L. Lam, Ana M. Hilvano-Cabungcal, Pam Royle, Fiona Stewart, Graeme MacLennan, Sara J. MacLennan, Steven E. Canfield, Sam McClinton, T.R. Leyshon Griffiths, Börje Ljungberg, Ja
European Urology.2012; 61(5): 972. CrossRef
Perioperative, Oncologic, and Functional Outcomes of Laparoscopic Renal Cryoablation and Open Partial Nephrectomy: A Matched Pair Analysis
Tobias Klatte, Julian Mauermann, Gertraud Heinz-Peer, Matthias Waldert, Peter Weibl, Hans Christoph Klingler, Mesut Remzi
Journal of Endourology.2011; 25(6): 991. CrossRef

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Case Report

A Case of Multiple Intussusceptions in the Small Intestine Caused by Metastatic Renal Cell Carcinoma: Wan Kyu Eo, Gou Young Kim, Sung Il Choi; Cancer Res Treat. 2008;40(2):97-99. Published online June 30, 2008; DOI: https://doi.org/10.4143/crt.2008.40.2.97

Abstract PDF PubReader ePub

Renal cell carcinoma (RCC) may metastasize to almost any organ, but metastasis to the small bowel is rare. Small bowel metastasis from RCC can induce obstruction or bleeding, and perforation can also be induced in rare case. Yet RCC metastasis to the small bowel is unlikely to be a direct cause of intussusceptions. A few cases of intussusceptions caused by small intestinal metastasis of RCC have been reported, but multiple small intestinal intussusceptions are extremely rare. We report here on a 47-year-old male patient who presented to the emergency room with acute abdominal pain. He had undergone radical nephrectomy 2 years previously due to left RCC. The abdominal CT scan revealed enhanced masses with the "target" sign that suggested enteric intussusceptions in the jejunum. Eight pedunculated masses within the small intestinal lumen led to intussusceptions at 30 and 150 cm distal to Treitz ligament. Three segmental resections of the small intestine and functional end to end anastomosis were done. The patient recovered uneventfully from this operation. To the best of our knowledge, this is the 1^st report of metastases from RCC that presented as synchronous intraluminal polypoid tumors, and these tumors served as the lead points for two intussusceptions in the jejunum.

Citations

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Case Report: Pancreatic metastasis of renal cell carcinoma 16 years after nephrectomy
Yidan Lou, Kaibo Guo, Song Zheng
Frontiers in Oncology.2023;[Epub] CrossRef
Solitary metastasis of clear cell renal cell carcinoma in the small intestine 10 years after right nephrectomy
M.D. Budurova, N.V. Vorobyov, S.I. Poluektov, V.S. Surkova, N.A. Grishin, K.A. Turupaev, M.A. Chernichenko, A.B. Ryabov
Onkologiya. Zhurnal imeni P.A.Gertsena.2023; 12(6): 57. CrossRef
Metastatic disease masquerading as small intestinal tumoural masses: two case reports and literature review
Jovell Xing Yi Sim, Ilyana Huda Binte Mohamed Hussain, Wei Qiang Leow
Proceedings of Singapore Healthcare.2017; 26(4): 263. CrossRef
Severe blood loss anaemia and recurrent intussusceptions as first presentation of bowel metastatic renal cell carcinoma: A case report and review of the literature
Claudia Trojaniello, Maria Giuseppa Vitale, Biagio Trojaniello, Maria Luisa Lentini Graziano, Mariarosa Coccaro, Giacomo Cartenì, Vincenzo Montesarchio
Molecular and Clinical Oncology.2017; 7(4): 654. CrossRef
Small bowel intussusception from renal cell carcinoma metastasis: a case report and review of the literature
Gabriele Bellio, Tommaso Cipolat Mis, Gladiola Kaso, Roberto Dattola, Biagio Casagranda, Marina Bortul
Journal of Medical Case Reports.2016;[Epub] CrossRef
Small bowel metastasis from pancreatic cancer in a long-term survival patient with synchronous advanced malignant pleural mesothelioma: A case report and literature review
Morena Fasano, Carminia Maria Della Corte, Giovanni Vicidomini, Valerio Scotti, Pier Francesco Rambaldi, Alfonso Fiorelli, Marina Accardo, Ferdinando De Vita, Mario Santini, Fortunato Ciardiello, Floriana Morgillo
Oncology Letters.2016; 12(6): 4505. CrossRef
Triple jejuno-jejunal intussusception due to metastatic renal cell carcinoma
A.-S. Massy Budmiger, V. Nagy, S. Hurlimann, J. Metzger
Journal of Surgical Case Reports.2015; 2015(4): rjv047. CrossRef
An obscure cause of gastrointestinal bleeding: Renal cell carcinoma metastasis to the small bowel
Robyn L. Gorski, Salah Abdel Jalil, Manver Razick, Ala' Abdel Jalil
International Journal of Surgery Case Reports.2015; 15: 130. CrossRef
Recurrent Renal Cell Carcinoma with Synchronous Tumor Growth in Azygoesophageal Recess and Duodenum: A Rare Cause of Anemia and Upper Gastrointestinal Bleeding
Vamshidhar R. Vootla, Muhammad Kashif, Masooma Niazi, Suresh K. Nayudu
Case Reports in Oncological Medicine.2015; 2015: 1. CrossRef
Atypical Multiple Ileum Metastases of Renal Cell Carcinoma
Raffaele Longo, Domenico Gattuso, Roberto Luchetti, Carlo Giannetti, Alessandro Mero, Cinzia Bernardi, Giampietro Gasparini
Journal of Gastrointestinal Cancer.2013; 44(4): 477. CrossRef
Enduring Response to Everolimus as Third-Line Therapy in a Patient With Advanced Renal Cell Carcinoma, Including Small-Bowel Metastases: Loss of FHIT but Normal VHL Gene Status
Reuben J. Broom, Imogen Caldwell, Fritha Hanning, Peter Fong, Sanjeev Deva, Paul Oei
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A case of wedge resection of duodenum for massive gastrointestinal bleeding due to duodenal metastasis by renal cell carcinoma
Hongzhi Zhao, Keqiang Han, Jing Li, Ping Liang, Guohua Zuo, Yu Zhang, Hongyan Li
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Malignant Pleural Mesothelioma Presenting as an Acute Surgical Abdomen due to Metastatic Jejunal Perforation
Kyoko Gocho, Kazutoshi Isobe, Kyohei Kaburaki, Yoshiko Honda, Aki Mitsuda, Yoshikiyo Akasaka, Nagato Shimada, Keigo Takagi, Sakae Homma
Internal Medicine.2010; 49(6): 597. CrossRef

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Original Articles

Apoptosis in Renal Cell Carcinoma: Correlation to Apoptosis Related Genes and Cell Proliferation, and Its Prognostic Significance: Ji Shin Lee, Jong Jae Jung, Sung Taek Lee, Chang Soo Park; J Korean Cancer Assoc. 2001;33(1):9-15.

Abstract PDF: PURPOSE
To investigate the prognostic role of apoptosis and to evaluate the relationship between apoptosis and apoptosis-related genes, as well as cell proliferation in renal cell carcinoma (RCC).
MATERIALS AND METHODS
Apoptosis was detected by using the terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick-end labeling (TUNEL) technique in 67 formalin-fixed and paraffin-embedded RCC specimens. Immunohistochemical stainings for p53 and retinoblastoma (Rb) proteins and proliferating cell nuclear antigen (PCNA) were also conducted simultaneously.
RESULTS
The apoptotic index (AI) varied from 0.2% to 25.5%. The PCNA index (PI) ranged from 2.1% to 70.3%. The expression of p53 protein was found in 31 of 67 (46.3%) cases. Abnormal expression of Rb was seen in 23 of 67 (34.3%) cases. There was a statistically significant positive correlation between AI and increasingnuclear grade (p<0.001). A significant correlation was found between AI and PI (r=0.329, p<0.01). When comparing the AI with the expression of p53 and Rb proteins, there was no significant difference. In univariate survival analysis, nuclear grade, TNM stage, PI, expression of Rb and AI were significantly associated with shortened survival. However, TNM stage was the only independent prognostic factors by multivariate analysis.
CONCLUSION
The present findings indicate that apoptosis in RCC is closely associated with cell proliferation, but not with the expression of p53 and Rb proteins. In multivariate analysis, the AI does not carry an independent prognostic significance.

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Correlation between Genetic Polymorphism of CYP2D6 and CYP1A1 and Susceptibility of Renal Cell Carcinoma in Korean: Kyu Wook Park, Se Il Jung, Gyung Woo Jung, Heon Young Kwon, Jin Sook Jeong, Jin Ho Chun, Jin Han Yoon; J Korean Cancer Assoc. 2000;32(4):801-809.

Abstract PDF: PURPOSE
Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean.
MATERIALS AND METHODS
Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA.
RESULTS
In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented.
CONCLUSION
There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.

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The Effect of Immunotherapy Based on Interferon - alpha in Advanced Renal Cell Carcinoma: Seung Hyun Jeon, Sung Goo Chang; J Korean Cancer Assoc. 1999;31(5):986-994.

Abstract PDF: PURPOSE
Recently in light of the development in immunology, interferon- e and inter- leukin-2 or combination therapy with anticancer drugs have been performed. This study aims to verify and compare the efficacy of therapies using interferon- a alone, interferon- a plus vinblastine, and interferon- a plus interleukin-2 plus 5-fluorouracil (5-FU) plus 13-cis retinoic acid (13cRA) in patients with advanced renal cell carcinoma.
MATERIALS AND METHODS
A total of 29 patients were randomly assigned to receive treatment with either interferon- a alone or interferon- a plus vinblastine or interferon- a plus interleukin-2 plus 5-FU plus 13cRA from December 1989 to May 1998. The most frequent metastatic sites were the lung, lymph nodes, bone, liver, and brain. We studied the response rates, survival period, and complications of each regimen.
RESULTS
Responses were achieved in 1 out of 1~5 patients (6.73?o) on interferon- a alone (partial responses lasting 13 months), 1 out of 9 patients (11.1%) on interferon- e plus vinblastine (partial responses lasting 25 months) and 1 out of 5 patients (20.0%) on interferon-a plus IL-2 plus 5-FU plus 13cRA regimen (partial responses lasting 14 months). The median durations of survival were 18, 33, and 23 months respectively. The overall response rate was 10.3% and overall median duration of survival was 19 months. The most common side effects were flu-like symptom such as fever, chills (93.1%), skin symptom such as erythema, pruritus (31.0%), G-I symptom such as nausea, vomiting (17.2%), netropenia (10.3%), abnormal LFT (10.3%), and thrombocytopenia (3.4%).
CONCLUSIONS
This study confirms the manageability and tolerability of several regimen used. There is no significant differences in response rates and survival duration among the regimens used in this study. The effective immunotherapy in patients with metastatic RCC should be evaluated by further studies of larger patients groups even though a minority of patients responded.

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Comparison of Rb and p53 Protein Expression with Stage and Grade as a Prognostic Value in Renal Cell Carcinoma: Hye Jeong Choi, Mi Jin Ko, Mi Jin Kim, Dong Sug Kim; J Korean Cancer Assoc. 1999;31(5):979-985.

Abstract PDF: PURPOSE
This study was performed to evaluate prognostic significance of Rb and p53 protein immunostaining in renal cell carcinoma. We investigated correlations between Rb, p53 immunostaining and nuclear grade and stage as prognostic factors of renal cell carcinoma.
MATERIALS AND METHODS
Subjects of this study were sixty-nine cases of renal cell carcinoma. We used indirect immunohistochemical methods in the formalin-fixed paraffin- embedded tissue (Rb: Pharmingen, USA; p53: Novocastra, UK). In staging and nuclear grading of the renal cell carcinoma, the American Joint Commitee on Cancer (AJCC) TNM system and Fuhrmans grading system were applied respectively.
RESULTS
According to Fuhrmans grading system, four cases were classified grade I, 15 cases were classified grade II, 13 cases were classified grade III, and 37 cases were classified grade IV. By AJCC TNM staging system, 29 cases were grouped stage I, 20 cases were grouped stage II, 15 cases were grouped stage III and five cases were grouped stage IV. In 55 cases (79% of all cases), Rb protein was expressed. Expression of Rb protein did not correlate with nuclear grade nor tumor stage. p53 protein was expressed in 17 cases (24% of all cases). p53 protein expression was frequently detected in high nuclear grade group (p < 0.05), but was not correlated with tumor stage.
CONCLUSION
Expression of Rb protein was not conelated with nuclear grade and stage. And expression of p53 protein was not correlated with stage, but it is correlated with nuclear grade. Thus immunohistochemical examinstion of p53 could be a histological prognostic factor.

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Case Report

A Case of Synchronous Gastric Non - Hodgkin's Lymphoma and Renal Cell Carcinoma: Je Jung Lee, Moo Rim Park, Young Eun Joo, Young Jin Kim, Hyeoung Joon Kim, Chan Choi, Ik Joo Chung; J Korean Cancer Assoc. 1999;31(3):635-640.

Abstract PDF: We report a 58-year-old man who developed synchronous gastric non-Hodgkin`s lymphoma (NHL) and renal cell carcinoma. He presented with epigastric discomfort for 2 months. Endoscopic finding of the stomach disclosed a large inegular ulceration with nodular margin on the upper body. Constrast enhanced CT scan of the abdomen showed an ulceration and focal wall thickening in the greater curvature side of stomach, and an enhanced bulging mass in the left kidney incidentally. The tissue obtained by radical proximal gastrectomy and nephrectomy showed diffuse large B-cell lymphoma on stomach and chromophobic type of renal cell carcinoma on kidney. To our knowledge, this is the first report of synchronous gastric NHL and renal cell carcinoma in Korea.

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Original Articles

Clinical Study of Stage I Renal Cell Carcinoma: Heeyoul Kim, Won Hee Woo, Duk Kyo Kim, Sei Kyung Rho, Sun Ju Lee, Sung Goo Chang; J Korean Cancer Assoc. 1997;29(6):1100-1105.

Abstract PDF: PURPOSE
This study was attemped to investigate the prognostic factors for the outcome of stage I renal cell carcinoma after radical nephrectomy.
MATERIALS AND METHODS
Twenty nine patients treated from 1984 to 1995 at Kyung Hee University Medical Center were studied retrospectively. All of them were diagnosed with pathologic Robson stage I renal cell carcinoma after radical nephrectomy.
RESULTS
Males were affected three times more frequently than females. The tumor was detected on the right kidney in 15 cases, and on the left in 14. Average follow up period was 36.6 months, average disease free interval was 29.4 months and median survival was 30 months. During the follow up, 9 patients (31.0%) expired due to liver and lung metastasis at postoperate 21.6 months on average. Eleven patients (37.9%) developed distant metastasis in the follow up. There was no local recurrence of tumor. Seventeen patients were diagnosed incidentally without clinical symptoms. In our retrospective study for stage I renal cell carcinoma, there were no predictive prognostic parameters for predicting the outcome of patients, except for the incidental diagnosis of the tumor.
CONCLUSIONS
These results suggest that incidental diagnosis of the tumor may be the most important prognostic factor for the outcome of stage I renal cell carcinoma. Although the patients were confirmed as stage I renal cell carcinoma pathologically after radical nephrectomy, close follow up is very important, because of high incidence of metastasis. We recommand that chest X-ray, abdominal ultrasonogram and bone scan should be checked at 3 months interval for postoperative one year even though stage I renal cell carcinoma.

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Renal Cell Carcinomas with Odd Pattern of Metastasis: Jung Sik Oh, Hyun Muck Lim, Sun Taik Chang, Yong Wook Park, Jae Hyung Yoo, Woo Chul Moon; J Korean Cancer Assoc. 1994;26(2):351-360.

Abstract PDF: Patients with metastatic renal cell carcinoma(RCC) usually have a dismal prognosis with a median survival duration of 12 months despite intensive systemic therapy of varioue modalities. The role of surgical removal of metastatic tumor is controversial, RCC usually shows predictable pattern of metastasis, preferentially to lung, lymph node, bone, liver and adrenaL It is rare for general surgeon to have a chance to see and operate the metastatic RCC. We herein report two cases of RCC which produced metastaaes of odd pattern and were treated by surgical removal of the metastatic organ at the department of general surgery with good outcomes. One patient presented with RCC with metastasis to gall bladder, which was treated by radical nephrectomy and cholecystectomy. The other patient presented with thyroid mass, which was confirmed as metastatic RCC after thyroidectomy. He had history of surgery for metastatic RCC to skin, lung and ethmoid bone sequentially every 2 years during past 9 years after nephrectomy. The 2 cases suggest that RCC can produce metastases of very unusuall location, induding gall bladder and thyroid and preaentation long time after nephrectomy, and in which cases ag- gressive surgical removal of the metaatatic tumor may be of benefit.

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A Case of Spontaneous Regression of Matastatic: Soo Jeong Park, Sang Jae Lee; J Korean Cancer Assoc. 1996;28(2):387-394.

Abstract PDF: Renal cell carcinoma accounts for 85% of all primary renal neoplasm. Its most common sites of distant metastses include lung, 1iver, bone, central nervous system, soft tissue. The treatment of metastatic renal cell carcinoma remain a major problem in clinical medicine. Hormonal therapies, chemotherapies or in combinations, and immunotherapic approaches to this tumor seldom result in objective tumor regression or prolongation of survival and the response are usually temporary. Fewer than 1% of patients with renal cell carcinoma are reported to experience spontaneous regression of metastatic lesions after nephrectomy. We report a case of spontaneous regression of metastatic renal cell carcinoma, which showed bilateral multiple lung metastases, multiple bone involvements, and subcutaneous nodules, with the review of literatures.

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Effect of Combination Chemotherapy with Recombinant Interferon Alpha-2a for Palliative Therapy of metastatic Renal Cell Carcinoma: Jae Cheon Ahn, Seong Choi, Hyun Yul Rhew; J Korean Cancer Assoc. 1996;28(3):555-562.

Abstract PDF: The prognosis for metastatic renal cell carcinoma is poor, and also there is no effective treatment for this cancer. Recombinant interferon alpha-2a displays subadditive. additive, and synergic effects when used with a number of cytotoxic agents is vitro and in vivo tumor models. A total of 3l petients with metastatic renal cell carcinoma was recieved recombinant interferon alpha-2a, vinblastine, CCNU and medroxyprogesterone acetate between March 1988 and December 1993. Their mean age was 53.8 years (range; 14 - 78 years).The male to female ratio was 2.1:1. Histologically, clear cell type was dominant (83.8%).Lung metastasis only was in 13 cases(41.9%) and multiple metastasis was in 18cases.Using the deKerion criteria for response, the response rate was 29%(9 cases). The 1,2,5 year survival rates of all the patients were 48%, 18%, 18% respectively, 100%, 60%, 60% for the responder group and 24%, 8%, 0% for the nonresponder (p=0.004).In combination chemothetherapy with recombinant interferon alpha-2a, the Karnofsky performance index was the most significant prognostic factor(p=0.015). Age, sex, metastatic sites, cell type and disease free interval had no significance(p>0.05).The most common side effects were constitutional symptoms(93.5%).Hematologic toxicity(41.9%),G-I toxicity(41.9%) and hepatic toxicity(6%) occured. In conclusions, combination chemotherapy with recombinant interferon alpha-2a raised remssion and survival rates and can be on effective palliative therapy in patients with metastatic renal cell carcinoma.

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