Nephrectomy For Tumors Research Articles

Partial and radical nephrectomy in children, adolescents, and young adults: Equivalent readmissions and postoperative complications

ObjectivesTo compare and contrast the use of partial nephrectomy (PN) and radical nephrectomy (RN) in pediatric malignant renal tumors using a nationally representative database. MethodsThe 2010–2014 Nationwide Readmissions Database (NRD) was used to obtain PN and RN select postoperative data. ICD-9-CM codes were used to identify children (<10 years), adolescents (10–19 years) and young adults (20–30 years) diagnosed with malignant renal tumors who were treated with a PN or RN. The presence of a 30-day readmission, occurrence of postoperative complications, cost, and length of stay (LOS) were studied and weighted logistic regression models were fit to test for associations. ResultsThere were 4330 weighted encounters (1289 PNs, 3041 RNs) that met inclusion criteria: 50.8% were children, 7.2% were adolescents, and 42% were young adults. Young adults had the highest rates of PN, whereas children had the highest rates of RN (p < 0.0001). Overall, no evidence was found to suggest a difference in odds between surgical modality and the presence of a 30-day readmission or postoperative complication. While PN was on average $9000 cheaper compared to RN overall, its cost was similar to that of RN for children. Similarly, PN patients had a shorter overall LOS compared to RN patients, but their LOS was similar to that of children who underwent RN. ConclusionThere was no evidence of a difference in odds between RN and PN in terms of postoperative readmissions or in-hospital complication rates. Additionally, we observed descriptive differences in both cost and LOS between the surgical modalities across age groups. Type of studyRetrospective comparative study (administrative database analysis). Level of evidenceLevel III.

Robotic-assisted laparoscopic management of renal tumors in children: Preliminary results.

We present the preliminary results of robotic-assisted laparoscopic (RAL) total and partial nephrectomy for renal malignant tumors in children. This is a prospective study of patients operated with RAL between December 2016 and September 2018. Patients with Wilms tumors were treated according to the SIOP-2001 protocol. Patient and tumor characteristics, type of surgery, surgical-related morbidity, and oncologic outcomes were recorded. Results were compared with a series of patients with similar age- and tumor-related characteristics operated during the same period by an open surgical approach. Ten children underwent RAL nephrectomy with a mean age of five years (3.2-14.1 years). Total nephrectomy was done in six cases for Wilms tumor and in one case for renal sarcoma; three cases were converted. Complete removal of tumor without rupture was achieved in all cases. Postoperative course was uneventful, and patients were discharged between days 2 and 7. Neither recurrence nor medium-term complications occurred. Nine patients are alive with a median follow-up of 16 months (6-27 months) and one female died from complications of central nervous system metastases one year after surgery. When compared with the open surgical approach group, median tumor volume was smaller (P=0.005), hospital stay was shorter (P=0.01), and operative time was similar (P=0.20). RAL total and partial nephrectomy procedure for renal tumor in children may be an option in carefully selected cases. Indication should be discussed at tumor boards and surgery performed while adhering strictly to oncological surgical rules.

Application of fast-track surgery in the perioperative period of laparoscopic partial nephrectomy for renal tumors.

ObjectivesThis study aimed to examine application of fast-track surgery (FTS) in the perioperative period of laparoscopic partial nephrectomy for renal tumors, and to discuss its effects and safety.MethodsEighty patients who received laparoscopic partial nephrectomy in urinary surgery from January 2016 to December 2017 were selected and randomly classified as the observation group (n = 40) and control group (n = 40). Traditional treatments were performed in the control group, while FTS was applied in the observation group. The complication rate after the operation was recorded.ResultsThe duration of the operation and intraoperative blood loss were not different between the groups. The duration of anesthesia and fluid transfusion volume on the day of the operation were significantly less in the observation group than in the control group. The rates of infection of the incisional wound, nausea and vomiting, and anastomotic stomal bleeding were not significantly different between the groups. However, the rates of postoperative urinary tract infection, abdominal distension, thirst, hypothermia, and pulmonary infection were significantly lower in the observation group than in the control group.ConclusionApplication of FTS in laparoscopic partial nephrectomy contributes to postoperative recovery and reduction of postoperative complications.

The planning, simulating and executing for the surgery of bilateral renal masses used the three-dimensional intelligent qualitative and quantitative analysis system(IQQA)

Objective To explore the application of three-dimensional intelligent qualitative and quantitative analysis system (IQQA) in the planning, simulation and implementation of precise surgery for bilateral renal tumors. Methods A retrospective analysis a total of 7 patients with bilateral kidney tumors in our center from June 2017 to August 2018 was performed. There were 5 males and 2 females, with an average age of (54.6±6.0)years , ranging 47.0-63.0 years. The average BMI index was (23.4±2.4) kg/m2, ranging 21.2-28.0 kg/m2. The average diameter of 14 renal tumors in 7 patients was (3.8±1.1) cm, ranging 1.9-5.3 cm. The average R. E.N.A.L score was 6.6±1.2 , ranging 5.0-9.0. The tumor stage was T1N0M0. The mean preoperative hemoglobin, albumin, creatinine and GFR were (138.6±17.0)g/L and (47.3±2.5 g/L), (51.6±19.1)μmol /Land (56.9±6.7)ml/min, respectively. Before operation, the original data of CT were input into IQQA system. Then we reconstructed kidney, blood vessel, collecting system and tumors using system. And the structure of kidney, tumors and vessels was visualized directly. The systematic analysis of the operation is carried out at terminals vary from various angles, and the surgical resection simulation. The position, angle and curvature of the cut surface are adjusted according to the effect. The plan of partial nephrectomy is designed. The resection area, remaining area of kidney is calculated. In this way, we can construct individualized and accurate laparoscopic partial nephrectomy planning before operation. Last, we carried out the operation according to the designed plan. The laparoscopic standard partial nephrectomy was performed in 11 cases. The laparoscopic selective partial nephrectomy was performed in 2 cases. One underwent laparoscopic partial nephrectomy without obstruction. We achieved precise resection of tumors and rapid suture of wounds according to the preoperative planning of excision and suture. We collected of the surgical success rate, conversion to opening rate, operation time, warm ischemia time, intraoperative bleeding volume, complications and hospitalization after operation. The related laboratory indicators such as eGFR and creatinine were followed up for 3 months, and the prognostic indicators such as renal CT and pulmonary CT for 6 months after operation were evaluated and analyzed. Result 14 renal tumors were successfully reconstructed by IQQA in 7 patients. The operations were completed successfully without conversion to open surgery or radical nephrectomy. The average operative duration was (68.9±9.2) minutes, ranging 50.0-80.0 minutes. The average renal artery occlusion duration was (20.7±4.1) minutes, ranging 15.0-29.0 minutes. The average intraoperative bleeding volume was (70.7±29.7) ml, ranging 30.0-120.0 ml. The average indwelling time of drainage tube was (5.5±0.7) days, ranging 5.0-7.0 days. The average hospitalization time was (6.3±0.5) days, ranging 6.0-7.0 days. There were no perioperative complications such as bleeding, urinary leakage, infection, incision dehiscence and pulmonary infection. Postoperative pathology revealed 13 clear cell renal carcinoma and 1 renal angiomyoma. No recurrence or metastasis was found in chest CT and lung CT after 6 months follow-up. The creatinine and GFR in 3 months after operation were (52.0±15.2)μmol/L(36.0-72.0 μmol/L)and (56.7±5.3)ml/min(46.7-66.3 ml/min). There was no significant difference of creatinine and GFR with the preoperative (P>0.05). The mean Hb and albumin levels in 3 months after operation were (120.9±17.0)g/L(90.0-147.0 g/L) and (41.4±2.6)g/L(38.0-46.0 g/L), which were significantly lower than those before operation (P<0.05). Conclusions The three-dimensional intelligent qualitative and quantitative analysis system (IQQA) can visualize the kidney, tumor and the vasculature of bilateral kidney tumors by preoperative three-dimensional reconstruction. The optimal surgical plan of partial nephrectomy can be designed by preoperative operation planning and computer terminal in order to enhance the safety of partial nephrectomy for bilateral kidney tumors and preserve the possibility of kidney, and protect the renal function to the greatest extent. To accurately predict the retention of renal function after operation, so that patients with bilateral renal tumors can get the greatest benefit in partial nephrectomy. Key words: Bilateral renal tumors; Intelligent qualitative and quantitative analysis; Laparoscopic partial nephrectomy; Surgical planning

Tumor size and postoperative kidney function following radical nephrectomy.

Background: Chronic kidney disease (CKD) following nephrectomy for kidney tumors is common, and both patient and tumor characteristics may affect postoperative kidney function. Several studies have reported that surgery for large tumors is associated with a lower likelihood of postoperative CKD, but others have reported CKD to be more common before surgery in patients with large tumors.Objective: The aim of this study was to clarify inconsistencies in the literature regarding the prognostic significance of tumor size for postoperative kidney function.Study design and setting: We analyzed data from 944 kidney cancer patients managed with radical nephrectomy between January 2012 and December 2013, and 242 living kidney donors who underwent surgery between January 2011 and December 2014 in the Australian states of Queensland and Victoria. Multivariable logistic regression was used to assess the primary outcome of CKD upstaging. Structural equation modeling was used to evaluate causal models, to delineate the influence of patient and tumor characteristics on postoperative kidney function.Results: We determined that a significant interaction between age and tumor size (P=0.03) led to the observed inverse association between large tumor size and CKD upstaging, and was accentuated by other forms of selection bias. Subgrouping patients by age and tumor size demonstrated that all patients aged ≥65 years were at increased risk of CKD upstaging, regardless of tumor size. Risk of CKD upstaging was comparable between age-matched living donors and kidney cancer patients.Conclusion: Larger tumors are unlikely to confer a protective effect with respect to postoperative kidney function. The reason for the previously reported inconsistency is likely a combination of the analytical approach and selection bias.

71 - Microwave thermal ablation versus open partial nephrectomy in treatment small renal tumors between patients over 70 years old

71 - Microwave thermal ablation versus open partial nephrectomy in treatment small renal tumors between patients over 70 years old

Utility of cytokeratin 7, S100A1 and caveolin-1 as immunohistochemical biomarkers to differentiate chromophobe renal cell carcinoma from renal oncocytoma.

Differentiation of chromophobe renal cell carcinoma (chRCC) from benign renal oncocytoma (RO) can be challenging especially when there are overlapping histological and morphological features. In this study we have investigated immunohistochemical biomarkers (cytokeratin 7/CK7, Caveolin-1/Cav-1 and S100 calcium-binding protein A1/S100A1) to aid in this difficult differentiation and attempted to validate their use in human renal tumour tissue to assess their discriminatory ability, particularly for chRCC and RO, in an Australian cohort of patients. Retrospective study was carried out of archived formalin-fixed paraffin-embedded renal tumours from tumour nephrectomy specimens of 75 patients: 30 chRCC, 15 RO and 30 clear cell RCC (ccRCC). Sections were cut and immunostained with specific polyclonal antibodies of CK7, Cav-1 and S100A1. Morphometry was used to determine expression patterns of the biomarkers using Aperio ImageScope. Results were assessed with student t-test and ANOVA with significance at P<0.05. From this cohort, male-to-female ratio was 1.9:1. Median age was 64 (45-88 years) and median tumour size was 3.8 cm (range, 1.2-18 cm). There were 47 (62.7%) T1, 7 T2, 20 T3 and one T4 stage of RCC; with 2 patients presenting with M1 stage. There was significantly higher CK7 expression in chRCC compared to RO (P=0.03), and chRCC also had a different staining pattern and higher expression of Cav-1 compared to RO. There was higher expression of S100A1 in RO compared to chRCC. Immunohistochemical staining and standard morphometry of CK7, Cav-1 and S100A1 can aid in the differentiation of chRCC and RO. This may guide clinicians in management of patients when faced with difficult diagnostic histological distinction between the two tumour subtypes.

Value of Partial Nephrectomy for Renal Cortical Tumors of cT2 or Greater Stage: A Risk-benefit Analysis of Renal Function Preservation Versus Increased Postoperative Morbidity

BackgroundIndications for partial nephrectomy (PN) have expanded to include larger tumors. Compared with radical nephrectomy (RN), PN reduces the risk of chronic kidney disease but is associated with higher morbidity. ObjectiveTo explore whether the benefit of PN (preservation of estimated glomerular filtration rate [eGFR] ≥60ml/min/1.73m2 1yr postoperatively) over RN is offset by higher morbidity for cT2-cT3a tumors. Design, setting, and participantsA total of 1921 patients with renal cortical tumors who underwent nephrectomy between 2000 and 2012 were analyzed, with 297 having clinical stage T2 or higher disease. Outcome measurements and statistical analysisMultivariable logistic regression models adjusted for age, tumor size, and comorbidities were used to calculate the risk of complications within 90d and the risk of low eGFR across a range of tumor sizes. Models were created separately for RN and PN, and the difference between risk estimates was calculated. Results and limitationsFor tumors with diameters between 7 and 12cm, the risk of eGFR downgrade associated with RN was higher than the risk of complications associated with PN. The magnitude of the risk of eGFR downgrade was similar to the magnitude of complications risk across all tumor sizes. Our analysis was performed at a single institution, and used only tumor size to compare the risk and benefits of surgery. ConclusionsOur study suggests that PN is associated with higher eGFR preservation than RN for cT2 or greater renal tumors. The magnitude of this advantage offsets the higher morbidity observed with PN. Patient summaryWhen treating a large kidney tumor, it is difficult to decide whether it is better to remove the whole kidney or remove just the tumor. The second option improves postoperative renal function but is more complex. We tried to find whether there is a tumor size at which one technique should be used over the other.

Association between tumor contact surface area and parenchymal volume change in robot-assisted laparoscopic partial nephrectomy carried out using the enucleation technique.

To evaluate the change in the operated parenchymal volume during robot-assisted partial nephrectomy limited to the enucleation technique, and to analyze the predictors of decrease in operated parenchymal volume, including the tumor contact surface area. The study included 135 patients who underwent robot-assisted partial nephrectomy for T1 renal tumors using the enucleation technique. Measurements of the parenchymal volume, tumor volume and contact surface area were obtained in the venous phase on enhanced computed tomography. All measurements, including volumetric and renal function analysis, were carried out <2months before and 6months after surgery. The mean age of included participants was 56years, and the mean tumor size was 33mm. The mean tumor volume was 26cc, and the mean contact surface area was 22cm2 . In the complete cohort, the mean preoperative and postoperative normal parenchymal volumes of the operated kidney were 158 and 141cc, respectively. The mean change in parenchymal volume of the operated kidney was -10%. In contrast, the mean change in global estimated glomerular filtration was just -4.0%. Univariate analysis showed that the RENAL nephrometry score, contact surface area, tumor volume and warm ischemia time were associated with the change in the operated kidney parenchymal volume. However, in the multivariate analysis, a large contact surface area was the only independent predictor of decreased operated parenchymal volume <10cm3 . Contact surface area is a strong predictor of the decrease in the parenchymal volume in the operated kidney during robot-assisted partial nephrectomy carried out using the enucleation technique for T1 renal tumors.

Comparative analysis of short-term results of retroperitoneoscopic and laparoscopic radical nephrectomy for large kidney tumors

The study objective is to perform comparative analysis of short-term results of retroperitoneoscopic and laparoscopic radical nephrectomy for large kidney tumors. Materials and methods . The study is based on the results of examination and treatment of 108 patients with stage Т 1—3 а renal cell carcinoma. Results . For retroperitoneoscopic radical nephrectomy, significant decrease in operative time, ligation and transection of the renal hilum, lower carbon dioxide expenditure, less intense pain sensations on day 1 after the surgery, lower analgesics expenditure, and hospitalization time. Conclusion . The results show the advantages of retroperitoneoscopic radical nephrectomy compared to laparoscopic nephrectomy.

Características clínicas, resultados funcionales y oncológicos de los pacientes con tumores renales tratados con nefrectomía parcial

Antecedentes: La nefrectomía parcial (NP) se ha convertido en el manejo estándar de los tumores T1 (£ 7cm) y/o en riñón único, tumores bilaterales y cáncer hereditario. En México existen pocos estudios que reporten los resultados de dicho procedimiento.&#x0D; Objetivo: Conocer las características clínicas, morbilidad perioperatoria y resultados oncológicos y funcionales de la NP en el INCan.&#x0D; Materiales y métodos: Estudio retrospectivo y analítico de los pacientes de NP del año 2000 al 2018. Se reportaron resultados oncológicos y perioperatorios.&#x0D; Resultados: Se analizaron 79 pacientes con 82 NP. Edad media 52 años. El T clínico fue T1a y T1b en 62 (74.6%) y 20 (24.4%) casos respectivamente. Se realizó isquemia caliente en 39 (47.6%) y sin isquemia en 35 (42.7%). La media de tiempo quirúrgico, sangrado y estancia hospitalaria fue de 162 min, 449 ml y 2.1 días respectivamente. El abordaje abierto fue en 70 (85.4%) y laparoscópico en 12 (14.6%). Las complicaciones tempranas se presentaron en 17 (20%) incluyendo 9 (11%) transfusiones; 66 (80.5%) procedimientos reportaron células claras. Los márgenes quirúrgicos fueron negativos en 73 (89%). La sobrevida cáncer específica y sobrevida global a los 5 años fue de 100% y 92% respectivamente. La media estimada de tasa de filtración glomerular (TFG) prequirúrgica fue 88ml/min y de 79ml/min al año. La isquemia renal influyó en la disminución de la TFG.&#x0D; Conclusiones: La CCN en nuestros pacientes muestra resultados similares a lo reportado en otros centros de experiencia internacional por lo que intentar realizarlo en todos los tumores T1 es seguro en nuestra población.

Metastatic Chromophobe Renal Cell Carcinoma: Presence or Absence of Sarcomatoid Differentiation Determines Clinical Course and Treatment Outcomes.

Sarcomatoid features (SF) in renal cell carcinoma (RCC) denote poor prognosis. Data for metastatic chromophobe RCC (ChRCC) with SF are limited. We studied clinical outcomes and genomic features in this setting. We performed a retrospective review of newly diagnosed metastatic ChRCC patients; end points included overall survival (OS), time to treatment failure (TTF), and time to metastatic recurrence (TTR) after nephrectomy for localized disease. A subset of patients underwent next-generation sequencing (NGS). Outcomes were compared using nonparametric tests. One hundred nine patients with metastatic ChRCC were identified including 29 with SF. Median TTR after nephrectomy was shorter for patients with versus without SF (2.7 months [95% confidence interval (CI), 0.7-6.9] versus 48.8 months [95% CI, 30.8-80.7], log rank P< .001). Median TTF during first-line therapy was shorter for patients with versus without SF (1.8 months [95% CI, 0.9-2.7] vs. 8.0 months [95% CI, 5.1-13.0]; log rank P< .001). No responses were observed in 6 patients treated with nivolumab including 4 with SF. Median OS was inferior for patients with versus without SF (38 months vs.7.5 months; hazard ratio, 4.7 [95% CI, 2.7-8.2]; P< .001). NGS, performed in 22 patients, showed that 64% and 45% harbored tumor protein P53 and phosphatase and tensin homolog alterations, respectively. Microsatellite instability high status was identified in 3 patients. Metastatic ChRCC patients with SF had worse outcomes compared with those without SF. Median TTR< 3 months for this subgroup supports close surveillance after nephrectomy for localized tumors. Lack of benefit with various systemic regimens warrants studying underlying biology and investigating novel agents.

MP20-20 SIMULATED REALITY-ASSISTED RESECTION OF ENDOPHYTIC RENAL TUMORS CAN ACHIEVE EQUIVALENT RESULTS TO EXOPHYTIC TUMOR IN ROBOT-ASSISTED PARTIAL NEPHRECTOMY

INTRODUCTION AND OBJECTIVES:Partial nephrectomy for endophytic tumor is not only difficult to identify the tumor site but also the risk of positivity surgical margin and prolongation of warm ischem...

MP42-20 A COMPARISON OF LONG-TERM OUTCOMES BETWEEN PARTIAL NEPHRECTOMY AND RADICAL NEPHRECTOMY FOR CLINICAL STAGE T1B AND T2A RENAL TUMORS

INTRODUCTION AND OBJECTIVES:Partial nephrectomy (PN) for T1b and T2a tumors has not been established as the reference standard treatment due to unclear functional benefit at the expense of increase...

Navigation of Intelligent/Interactive Qualitative and Quantitative Analysis Three-Dimensional Reconstruction Technique in Laparoscopic or Robotic Assisted Partial Nephrectomy for Renal Hilar Tumors.

Purpose: To evaluate the feasibility and effectiveness of the navigation of intelligent/interactive qualitative and quantitative analysis (IQQA) three-dimensional (3D) reconstruction technique in laparoscopic or robotic assisted partial nephrectomy (LPN or RAPN) for renal hilar tumors. Patients and Methods: The study retrospectively reviewed 26 patients with hilar tumors from February 2016 to February 2018. IQQA 3D reconstruction technique was applied for the purpose of navigation and resection of the tumors. Relevant clinical parameters and surgical outcomes were recorded. Results: All 26 LPN or RAPN were effectively completed without conversion to a hand-assisted or an open approach. Under the navigation of IQQA, all tumors were found precisely at the first time during surgeries. The mean operative time was 142 minutes (142 ± 35), with a mean warm ischemia time of 24.3 minutes (24.3 ± 9.5). The estimated blood loss was 156 mL (156 ± 112). No intraoperative complications occurred. Two patients suffered from postoperative complications. All patients had negative margins on the final pathological examination. At a mean follow-up period of 3 months, the mean glomerular filtration rate is 22.5 mL/min (22.5 ± 7.1) without tumor recurrence. Conclusions: With peculiar features, such as accurate location, complete resection, and fewer perioperative complications, the navigation of IQQA 3D reconstruction technique in partial nephrectomy represents a safe and effective procedure for hilar tumors.

330 - A prospective multicenter evaluation of predictive factors for positive surgical margins after partial nephrectomy for renal cell carcinoma: The RECORD2 project

INTRODUCTION AND OBJECTIVES:To assess the positive surgical margin (PSM) rate and to investigate for its predictors in patients treated with partial nephrectomy (PN) for localized renal tumors in a...

680 - The simplified PADUA RENAL (SPARE) nephrometry system predicts overall complication in patients who underwent partial nephrectomy for renal tumors

680 - The simplified PADUA RENAL (SPARE) nephrometry system predicts overall complication in patients who underwent partial nephrectomy for renal tumors

340 - Clinical and surgical predictors of medical and surgical postoperative complications in patients with limited life expectancy treated with partial nephrectomy for renal tumors: Insight from the RECORD2 project

340 - Clinical and surgical predictors of medical and surgical postoperative complications in patients with limited life expectancy treated with partial nephrectomy for renal tumors: Insight from the RECORD2 project

Elevated neutrophil to lymphocyte and platelet to lymphocyte ratios predict high grade and advanced stage renal cell carcinoma.

Renal cell carcinoma is the most common malignancy of the kidney, which accounts 85% of all renal tumors. In recent years, the incidence of renal cell carcinoma was increased due to the widespread use of imaging techniques. The aim of this study is to investigate the clinical significance of pretreatment neutrophil to lymphocyte and platelet to lymphocyte ratios in patients with renal cell carcinomas. The patients who underwent nephrectomy for renal tumor between 2010 and 2018 in two centers were reviewed retrospectively. The age, sex, complete blood test, and pathological results were recorded. The patients who were diagnosed with other carcinomas, benign renal tumors, and missing data of age, complete blood test, and pathological results, were excluded. The patients were divided into two groups according to the T stage and Fuhrman grade, T1-2 and T3-4, G1-2 and G3-4. There were 271 patients in the current study. The male to female ratio was 1.97 and the mean age of the patients was 59.37±11.62 years. Clear cell renal cell carcinoma was the most common subtype in 72.7% of the patients. Both the neutrophil to lymphocyte ratio and the platelet to lymphocyte ratio were significantly higher in patients with high-grade and advanced-stage disease than in the others. The receiver operating characteristic curve showed no significant difference between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio to diagnose the high grade and stage of renal cell carcinoma. The neutrophil to lymphocyte and platelet to lymphocyte ratios are easily accessible biomarkers which are used for the prognosis of malignancy. The current study found that these biomarkers may predict the pathological results during the preoperative period.

Molecular Profiling of Druggable Targets in Clear Cell Renal Cell Carcinoma Through Targeted RNA Sequencing.

Clear cell renal cell carcinoma (ccRCC) comprises more than 80% of all renal cancers and when metastasized leads to a 5-year survival rate of only 10%. The high rate of therapy failure and resistance development calls for reliable methods that provide information on the actionable biological pathways and predict optimal treatment protocols for individual patients. We here applied targeted RNA sequencing (t/RNA-NGS) using single molecule Molecular Inversion Probes on tumor nephrectomy samples of five ccRCC patients, comparing tumor with healthy kidney tissues. Transcriptome profiling focused on expression of genes with involvement in ccRCC biology that can be targeted with clinically available drugs. Results confirm high expression of vascular endothelial growth factor-A (VEGF-A) in tumor tissue relative to healthy-appearing kidney, in line with the angiogenic nature of ccRCC. PDGFRα and KIT, targets of the multi-kinase inhibitor sunitinib which is one of the current choices of first-line drug in metastasized ccRCC patients, were expressed at relatively low levels in tumor tissues, whereas significantly increased in normal kidney. Of all measured druggable tyrosine kinases, MET, AXL, or EGFR were expressed at higher levels in tumors than in normal kidney tissues, although intertumor differences were observed. Using cancer cell lines we show that t/RNA-NGS gene expression profiles can be used to predict in vitro sensitivity to targeted drugs. In conclusion, t/RNA-NGS analysis may provide insights into the (druggable) molecular make-up of individual renal cancers, and may guide personalized therapy of renal cell cancers.