RCC Group Research Articles

Short- and long-term outcome differences between patients undergoing left and right colon cancer surgery: cohort study

PurposeSince the literature currently provides controversial data on the postoperative outcomes following right and left hemicolectomies, we carried out this study to examine the short- and long-term treatment outcomes.MethodsThis study included consecutive patients who underwent right or left-sided colonic resections from year 2014 to 2018 and then they were followed up. The short-term outcomes such as postoperative morbidity and mortality according to Clavien-Dindo score, duration of hospital stay, and 90-day readmission rate were evaluated as well as long-term outcomes of overall survival and disease-free survival. Multivariable Cox regression analysis was performed of overall and progression-free survival.ResultsIn total, 1107 patients with colon tumors were included in the study, 525 patients with right-sided tumors (RCC) and 582 cases with tumors in the left part of the colon (LCC). RCC group patients were older (P < 0.001), with a higher ASA score (P < 0.001), and with more cardiovascular comorbidities (P < 0.001). No differences were observed between groups in terms of postoperative outcomes such as morbidity and mortality, except 90-day readmission which was more frequent in the RCC group. Upon histopathological analysis, the RCC group’s patients had more removed lymph nodes (29 ± 14 vs 20 ± 11, P = 0.001) and more locally progressed (pT3-4) tumors (85.4% versus 73.4%, P = 0.001). Significantly greater 5-year overall survival and disease-free survival (P = 0.001) were observed for patients in the LCC group, according to univariate Kaplan-Meier analysis.ConclusionsPatients with right-sided colon cancer were older and had more advanced disease. Short-term surgical outcomes were similar, but patients in the LCC group resulted in better long-term outcomes.

Alteration of pro-carcinogenic gut microbiota is associated with clear cell renal cell carcinoma tumorigenesis.

Increasing evidence suggests that gut microbiota is involved in the occurrence and progression of urinary system diseases such as clear cell renal cell carcinoma (ccRCC). However, the mechanism of how alteration of gut metagenome promotes ccRCC remains unclear. Here we aim to elucidate the association of specific gut bacteria and their metabolites with ccRCC. In a pilot case-control study among 30 ccRCC patients (RCC group) and 30 healthy controls (Control group), 16S ribosomal RNA (rRNA) gene sequencing were analyzed from fecal samples collected prior to surgery or hospitalization. Alpha diversity and beta diversity analysis of the gut microbiota were performed, and differential taxa were identified by multivariate statistics. Meanwhile, serum metabolism was measured by UHPLC-MS, and differential genes were identified based on the TCGA database. Alpha diversity found there were no significant microbial diversity differences of gut microbiota between the RCC group and the Control group. However, beta diversity analysis showed that the overall structures of the two groups were significantly separated (p = 0.008). Random Forests revealed the relative abundances of 20 species differed significantly between the RCC group and the Control group, among which nine species were enriched in the RCC group such as Desulfovibrionaceae, and 11 species were less abundant such as four kinds of Lactobacillus. Concomitantly, serum level of taurine, which was considered to be consumed by Desulfovibrionaceae and released by Lactobacillus, has decreased in the RCC group. In addition, macrophage-related genes such as Gabbr1 was upregulated in ccRCC patients. Reduction of protective bacteria, proliferation of sulfide-degrading bacteria Desulfovibrionaceae, reduction of taurine, and enrichment of macrophage related genes might be the risk predictors of ccRCC.

Cardiovascular profile of contemporary treatments of renal cell carcinoma: A single-center prospective study

BackgroundTyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) have revolutionized the treatment of metastatic renal cell carcinoma (mRCC). Emerging data suggest that these agents can result in clinically significant cardiotoxicity, compromising the care. MethodsWe conducted a prospective longitudinal study to evaluate the incidence of de novo cardiac dysfunction as assessed by echocardiography and blood biomarkers in mRCC patients receiving TKI with or without ICI followed at baseline, 3-month and 6-month. We recruited consecutive newly diagnosed mRCC patients treated at our institution between 2015 and 2018 as well as patients with localized RCC not treated with systemic therapies and healthy control (HC) subjects for comparison. ResultsTwenty-eight patients were enrolled in the mRCC group (a mean age of 65.2 ± 7.5 years), 29 patients in the localized RCC group (63.6 ± 8.9 years), and 20 volunteers in the HC group (52.9 ± 9.6 years). At baseline, patients from all three groups had normal cardiac function as measured by left ventricular ejection fraction (LVEF), although patients with mRCC or localized RCC had significantly lower mean LVEF compared to HC (61.9%, 62.4%, and 68.1% respectively). Otherwise, there were no statistically significant changes in echocardiographic parameters or incidence of clinical heart failure from baseline to 6-months in patients with mRCC. Cardiac blood biomarkers including troponin I, brain natriuretic peptide, and galectin-3 remained stable over time. ConclusionOur findings suggest that contemporary treatment strategies of mRCC at this single institution are well tolerated without clinically meaningful overt declines in cardiac function over time. Further studies are warranted to include a larger number of patients to better assess the overall cardiovascular safety associated with contemporary treatments of mRCC.

Triploidization modulates intestinal microbiota and promotes growth in Carassius auratus

Intestinal microbiota plays a key role in modulating host growth. However, the effect of triploidization on intestinal microflora and fast growth has not been fully explored. Here, autotriploid Carassius auratus (3nRR, 3n = 150) derived from Carassius auratus red var. (♀, RCC, 2n = 100) × autotetraploid fish (♂, 4nRR, 4n = 200) was established. Intestinal microbial community analysis of RCC and 3nRR was performed by 16S rRNA gene sequencing. Gut characteristics, growth rate, and digestive enzyme activity of the two groups of fish were explored. Significant changes in gut assemblages were observed in 3nRR fish. Differences in intestinal characteristics (structure, relative gut density, relative gut length, relative gut mass, and Zihler's index) were observed between RCC and 3nRR groups. Associations between microbial assemblages and intestinal characteristics were evaluated. Growth rate and activities of intestinal digestive enzymes (cellulase, amylase and trypsin) were higher in 3nRR compared with that in RCC. Spearman's correlation analysis showed a positive correlation between bacteria orders (Clostridiales, Micrococcales and Lactobacillales) and fast growth in 3nRR. In summary, the findings indicated that triploidization caused changes in gut microbiota and characteristics, and digestive enzyme activity. The relative abundance of several bacteria species was positively correlated with fast growth in 3nRR. The present study provided new insights into the growth mechanism of 3nRR and its interaction with intestinal microorganisms.

The gut microbiota composition in patients with right- and left-sided colorectal cancer and after curative colectomy, as analyzed by 16S rRNA gene amplicon sequencing

BackgroundGut pathological microbial imbalance or dysbiosis is closely associated with colorectal cancer. Although there are observable differences in molecular and clinical characteristics between patients with right- and left-sided colon cancer, differences in their gut microbiomes have not been thoroughly investigated. Furthermore, subsequent changes in microbiota status after partial colectomy remain unknown. We examined the human gut microbiota composition to determine its relationship with colon cancer and partial colon resection according to location.MethodsStool samples from forty-one subjects (10 in the control group, 10 in the right-sided colon cancer [RCC] group, 6 in the sigmoid colon cancer [SCC] group, 9 in the right colon resection [RCR] group and 6 in the sigmoid colon resection [SCR] group) were collected, and DNA was extracted. After terminal restriction fragment length polymorphism (T-RFLP) analysis, the samples were subjected to 16S rRNA gene amplicon sequencing, and the metabolic function of the microbiota was predicted using PICRUSt2.ResultsT-RFLP analysis showed a reduced ratio of clostridial cluster XIVa in the SCC patients and clostridial cluster IX in the RCC patients, although these changes were not evident in the RCR or SCR patients. 16S rRNA gene amplicon sequencing demonstrated that the diversity of the gut microbiota in the RCC group was higher than that in the control group, and the diversity in the SCR group was significantly higher than that in the RCR group. Principal coordinate analysis (PCoA) revealed significant differences according to the group. Analyses of the microbiota revealed that Firmicutes was significantly dominant in the RCC group and that the SCC group had a higher abundance of Verrucomicrobia. At the genus level, linear discriminant analysis effect size (LEfSe) revealed several bacteria, such as Ruminococcaceae, Streptococcaceae, Clostridiaceae, Gemellaceae, and Desulfovibrio, in the RCC group and several oral microbiomes in the SCC group. Metabolic function prediction revealed that cholesterol transport- and metabolism-related enzymes were specifically upregulated in the RCC group and that cobalamin metabolism-related enzymes were downregulated in the SCC group.ConclusionGut microbial properties differ between RCC and SCC patients and between right hemicolectomy and sigmoidectomy patients and may contribute to clinical manifestations.

Application of Imaging Indicators Based on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Colorectal Peritoneal Carcinomatosis.

ObjectiveThe imaging features of peritoneal carcinomatosis (PC) with different locations and pathological types of colorectal cancer (CRC) on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) were analyzed and discussed.MethodsThe PET/CT data of 132 patients with colorectal peritoneal carcinomatosis (CRPC) who met the inclusion and exclusion criteria between May 30, 2016, and December 31, 2019, were collected and analyzed. Observations included the location and pathological type of CRC, the peritoneal cancer index (PCI), standardized uptake maximum value (SUVmax), and retention index (RI) of the CRPC. Statistical analysis was performed using SPSS 20.0 software, and P < 0.05 was considered statistically significant.Results(1) The range of the PCI in the 132 patients studied was 2–30, with a mean value of 7.40 ± 8.14. The maximum long diameter of the CRPC lesions ranged from 0.6 to 12.1 cm, with an average of 3.23 ± 1.94 cm. The SUVmax ranged from 1.2 to 31.0, with a mean value of 9.65 ± 6.01. The SUVmax and size correlation coefficient for maximal CRPC lesions was r = 0.47 (P < 0.001). The RI range of the 72 patients who underwent time-lapse scanning was -10.0–112.2%, with RI quartiles of 13.5–48.9%; RI was ≥5% in 65 cases and <5% in seven cases. (2) The patients were grouped by the location of their CRC: the right-sided colon cancer (RCC, n = 37), left-sided colon cancer (LCC, n = 44), and rectal cancer groups (RC, n = 51). There were significant differences in the CRC pathological types (P = 0.009) and PCI scores (P = 0.02) between the RCC and RC groups and the RI between the RCC group and the other two groups (P < 0.001). (3) There were 88 patients organized into three groups by the pathology of their CRC: the moderately well-differentiated adenocarcinoma (group A, n = 57), poorly differentiated adenocarcinoma (group B, n = 16), and mucinous adenocarcinoma groups (group C, n = 15 cases, including one case of signet-ring cell carcinoma). There were significant differences in the CRC position (P = 0.003) and SUVmax (P = 0.03) between groups A and C.ConclusionThe PCI, SUVmax, and RI of peritoneal metastatic carcinoma caused by CRC in different locations and pathological types vary. Mucinous adenocarcinoma and poorly differentiated adenocarcinoma are relatively common in the right colon, and the PCI of peritoneal metastatic carcinoma is fairly high, but the SUVmax and RI are somewhat low.

Exposure-toxicity relationship of cabozantinib in patients with renal cell cancer and salivary gland cancer.

Cabozantinib is registered in fixed 60 mg dose. However, 46% to 62% of patients in the registration studies needed a dose reduction due to toxicity. Improved clinical efficacy has been observed in renal cell carcinoma patients (RCC) with a cabozantinib exposure greater than 750 μg/L. In our study we explored the cabozantinib exposure in patients with different tumour types. We included RCC patients from routine care and salivary gland carcinoma (SGC) patients from a phase II study with ≥1 measured C min at steady‐state. The geometric mean (GM) C min at the starting dose, at 40 mg and at best tolerated dose (BTD) were compared between both tumour types. Forty‐seven patients were included. All SGC patients (n = 22) started with 60 mg, while 52% of RCC patients started with 40 mg. GM C min at the start dose was 1456 μg/L (95% CI: 1185‐1789) vs 682 μg/L (95% CI: 572‐812) (P < .001) for SGC and RCC patients, respectively. When dose‐normalised to 40 mg, SGC patients had a significantly higher cabozantinib exposure compared to RCC patients (C min 971 μg/L [95% CI: 790‐1193] vs 669 μg/L [95% CI: 568‐788]) (P = .005). Dose reductions due to toxicity were needed in 91% and 60% of SGC and RCC patients, respectively. Median BTD was between 20 to 30 mg for SGC and 40 mg for RCC patients. GM C min at BTD were comparable between the SGC and the RCC group, 694 μg/L (95% CI: 584‐824) vs 583 μg/L (95% CI: 496‐671) (P = .1). The observed cabozantinib exposure at BTD of approximately 600 μg/L is below the previously proposed target. Surprisingly, a comparable exposure at BTD was reached at different dosages of cabozantinib for SGC patients compared to RCC patients Further research is warranted to identify the optimal exposure and starting dose to balance efficacy and toxicity.

Survival of patients with bilateral renal cell cancer after nephro-preserving surgery

This article presents a systematic literature review to assess the survival outcomes of patients with bilateral renal cell carcinoma who underwent nephro-preserving surgery. Patients with bilateral renal neoplastic lesions represent a rare subpopulation, numbering, according to different authors, from 2 to 6 % of the total RCC group. Despite the increase in the number of cases of bilateral RCC, the number of works devoted to the study of the features of surgical intervention, prognosis factors, treatment outcomes and survival of this cohort of patients is limited, and a number of important questions regarding this problem remain unresolved. Currently, the only effective method of treating bilateral renal cancer is nephro-preserving surgery in the volume of bilateral renal resection / nephrectomy with resection of the contralateral kidney in case of synchronous lesion or resection of a single kidney in case of metachronous lesion. This strategy avoids or reduces the risk of developing renal failure and its consequences after surgery. Conclusion. Nephro-preserving surgery for bilateral renal cell carcinoma is the only effective method to achieve satisfactory oncological results with a low incidence of complications.

Perioperative blood loss after embolization of hypervascular musculoskeletal tumors outside of the spine: A single-center ten year experience and systematic review of the literature

PurposeTo evaluate outcomes following trans-arterial embolization of hypervascular appendicular bony tumors in patients undergoing orthopedic resection by performing a systematic review including data from the authors' institution. Materials and methodsFrom April 2008 to August 2018, 73 patients (59 males, mean age 58.1 years) with musculoskeletal tumors presented for embolization for preoperative devascularization prior to orthopedic surgery. A retrospective chart review was performed to identify demographic, procedural and surgical data. A systematic review of the Pubmed, Medline, and Web of Science databases was performed to identify studies in which pre-operative embolization was performed of appendicular MSK tumors, and with measurements of estimated blood loss. All the variables listed above were recorded. A patient level analysis was performed to determine average estimated blood loss. Results58 patients (47 men, 11 women, range 21–84 years) were included in our institutional analysis. The median EBL was 500 mL (range 100–3000). There was no difference in EBL between RCC (719.6 ± 626.1) and non-RCC groups (855.6 ± 657.5); p = 0.44. The median intra-operative transfusion requirement was 1.0 unit (range 0–8 ± 2.06). From 1984 to 2015, 9 studies were identified that provided data for a total of 118 patients (46 males, 42 females, range 10–82 years). The mean and median post-surgical EBL across all patients was 976.9 ± 78.5 (SE) and 725 mL (range 10–7000), respectively. There were no complications related to non-target embolization. ConclusionPreoperative trans-arterial embolization of hypervascular MSK neoplasms appears to be safe and effective in minimizing peri- and post-operative bleeding while keeping transfusion requirements low.

Synchronous and metachronous colorectal liver metastases: impact of primary tumor location on patterns of recurrence and survival after hepatic resection.

Background:Considerable differences in terms of prognosis exist between the right-sided (RCC) and the left-sided colon cancer (LCC).Aim of the work:In this study, we evaluated prognostic implications of primary tumor location (PTL) among patients who underwent curative-intent hepatectomy for synchronous (SM) and metachronous (MM) colorectal liver metastases (CRLM).Methods:The study population included all consecutive patients affected by CRLM scheduled for first liver resection at three Italian oncological centers.Results:A total of 204 patients who underwent CRLM resection were included, 50% with RCC. Synchronous lesions were prevalent (n=133, 65%). Median OS was respectively 40.3 months for SM-RCC, 53.5 months for SM-LCC, 64.5 months for MM-RCC and 81.6 months for MM-LCC. Patients with MM-LCC showed an OS better than patients with SM-RCC (p=0.008) and SM-LCC (p=0.002). PTL had no influence on RFS. RCC group had less recurrences (75% vs 86.5%), though further surgery with curative-intent was possible more in LCC group (29.3% vs 32.5%). Cox proportional hazards model analysis showed that age and the presence of SM vs MM was associated with a significantly higher hazard ratio (HR) for death (HR=1.024; 95%CI=1.005-1.043; p=0.011 and HR=2.010; 95%CI=1.328-3.043; p=0.001, respectively).Conclusions:We confirmed that patients with CRLM and right-sided primary colon cancer experience worse survival after hepatic resection. The timing of metastasis has been revealed as important prognostic factor.

Vascular Pattern and Density in Clear Cell vs Clear Cell Papillary Renal Cell Carcinoma

Abstract Introduction/Objective Renal cell carcinomas (RCCs) are well-vascularized tumors. Although clear cell RCC (ccRCC) shows a characteristic vascular network, in some cases may show overlapping features with other RCCs. Microvessel density (MVD) and architectural vascular arrangement in RCC have been characterized using CD31 and CD34 immunohistochemical (IHC) stains. To date, no studies have evaluated the vascular distribution in ccRCC compared to clear cell papillary RCC (ccpRCC). We aimed to identify potential differences in MVD, vascular pattern architecture and extent in ccRCC and ccpRCC. Methods Fifteen cases of ccRCC and 15 cases of ccpRCC were included in the study. ERG IHC stain and Bioquant Osteo 2019 Imaging Analysis Software were used to evaluate MVD in 12 cases (6 ccRCC, 6 ccpRCC). CD34 was used to evaluate architectural vascular pattern and its extent (% of tumor) in all cases. Mann–Whitney U test in STATA version 16.0 was used for statistical analysis. Results MVD means were 30.64 (CI: 17.9-43.29) in ccRCC and 29.2 (CI: 17.82-40.57) in ccpRCC. CD34 highlighted 4 distinct vascular patterns: lacunae, pseudoacinar, Golgi-like and scattered. The extent of patterns ranged from 0% to 90%. Heterogeneous distribution of different vascular patterns was found in both RCC groups. Although lacunae pattern was present in all RCC cases, pseudoacinar (100.0% vs 31.0%), Golgi-like (53.8% vs 100%) and scattered (53.8% vs 38.0%) patterns showed different distribution in ccRCC vs ccpRCC, respectively. Lacunae+pseudoacinar was the most frequent combination in all ccRCCs; lacunae+Golgi-like was identified in 77% of ccpRCCs. Pseudoacinar was the most extensive pattern in ccRCCs, meanwhile Golgi-like was the predominant pattern in ccpRCCs (p value&amp;lt;0.05). Conclusion There was no difference in MVD between ccRCC and ccpRCC. However, the extent of vascular patterns pseudoacinar and Golgi-like was significantly different between ccRCC and ccpRCC. Distinct architectural vascular arrangement could help discriminate these entities.

Renal cell carcinoma: Associations between tumor imaging features and epidemiological risk factors

PurposeTo investigate associations between imaging features of tumors and age, gender and body mass index (BMI) in patients with renal cell carcinoma. MethodThis IRB-approved, HIPAA-compliant study included 1348 patients with histopathologically confirmed renal cell carcinoma of the clear cell subtype (ccRCC, n = 904) or non-clear cell subtype (n = 444), who underwent pre-treatment CT imaging less than 180 days before nephrectomy between 1999 and 2011. Two radiologists independently, retrospectively analyzed all imaging studies and identified features (necrosis, renal vein invasion, contact with renal sinus fat, multicystic appearance and nodular enhancement), which were then correlated with patient age, gender and BMI at time of surgery. ResultsInter-reader agreement on imaging features ranged from substantial to excellent (kappa: 0.688 to 0.982). In the ccRCC group, multicystic tumor appearance was significantly associated with lower patient age (p < 0.05) and lower BMI (p < 0.05); the presence of renal vein invasion was significantly associated with lower BMI in males (p < 0.05); and both tumor contact with the renal sinus and nodular enhancement were significantly associated with greater patient age (p < 0.05). In the non-clear cell RCC group, necrosis was associated with lower BMI for females (p < 0.05). ConclusionsThis study demonstrated significant associations between imaging features of RCC and patient age and BMI, hinting an influence of these factors on tumor biology and genomic make-up. These findings could aid future studies in selecting patients while investigating genomic, molecular and metabolic variables in RCC and might potentially impact on future stratification and therapy of patients.

The effect of Rosemary (Rosmarinus officinalis L.) distillation residues and linseed supply on fatty acid profile, meat colour, lipid oxidation and sensorial and hygienic quality of cull Barbarine ewes' meat.

To test the hypothesis that feeding cull ewes with Rosemary (Rosmarinus officinalis L.) distillation residues (RR) and linseed improves meat quality traits; fatty acid (FA) profile, lipid oxidation, meat colour, sensory and microbiological analysis were investigated. For this, 28 Barbarine ewes received 500g of basal diet and 700g of concentrate. Two groups received the control concentrate (CC) with, as basal diet, straw for CCC and straw plus 200g of RR for RCC group. The two other groups received the concentrate containing 10% of linseed (LC) with straw for CLC and straw plus 200g of RR for RLC group. The linseed intake increased n-3 PUFA (+28.7%) and C18:3n-3(+41%) and decreased n-6/n-3 ratio from 4.55 to 3.25; while the RR diet affected only the content of branched chain fatty acid in cull ewes' meat. Feeding RR combined to linseed delayed lipid oxidation at almost ½ at Day 9 (2.38 vs. 4.63 for RLC and CLC respectively). Meat from rosemary diet had higher tenderness and lower resilience. It is concluded that the meat obtained after rosemary and linseed supply can be regarded as healthier and shows higher quality traits and greater oxidation stability under chilling storage.

Abstract No. 399 Perioperative blood loss after embolization of hypervascular musculoskeletal tumors: a single-center 10-year experience

To assess outcomes following transarterial embolization of hypervascular bony tumors in patients undergoing orthopedic resection at our institution over a 10-year period. From April 2008 to August 2018, 73 patients with (59 males; mean age 58.1 years) with musculoskeletal (MSK) neoplasms presented for embolization for preoperative devascularization prior to orthopedic surgery and were retrospectively reviewed. Data collected includes demographic data, medical history, pertinent labs (i.e., hemoglobin levels), procedural information, surgical details (estimated blood loss (EBL), intraoperative transfusion), hospital course, and pathology. Fifty-eight patients (47 men, 11 women, range 21-84 years) were included in our analysis. Fifteen patients were excluded from this study (3 patients underwent angiography but were not embolized due to lack of large feeding branch vessel; 12 patients did not proceed to surgery after embolization). The median EBL was 500 mL (range, 100-3000). There was no difference in EBL between RCC (719.6 ± 626.1) and non-RCC groups (855.6 ± 657.5; P = 0.44). The median intraoperative transfusion requirement was 1.0 unit (range, 0-8 ± 2.06). 15.8% of patients required postoperative transfusion (median, 1.5 units; range 1-3). Of patients that received peri-operative transfusion, there was no difference in transfusion requirement in RCC and non-RCC groups (P = 0.88). Of the patients that did not get transfusions, the mean decrease in pre and postoperative hemoglobin was 1.41 g/dL (± 0.51g/dL). There were no complications related to non-target embolization. Preoperative transarterial embolization of hypervascular MSK neoplasms appears to be safe and effective in minimizing peri- and postoperative bleeding while keeping transfusion requirements low.

Wilms’ tumor 1 mRNA expression: a good tool for differentiating between myelodysplastic syndrome and aplastic anemia in children?

ABSTRACTObjectives: To evaluate the value of Wilms’ tumor 1 mRNA (WT1) expression in the differential diagnosis of childhood myelodysplastic syndrome (MDS) and aplastic anemia (AA).Methods: This study compared WT1 expression levels in children of MDS and AA to evaluate its value in differential diagnosis.Results: WT1 overexpression rate and mean WT1 expression level were significantly higher in MDS compared to AA (P = 0.000 and P = 0.013, respectively). Patients with RCC and normal cytogenetics exhibited significantly greater portion of patients exposing WT1 overexpression, compared to all AA subtypes (P = 0.001, P = 0.000 and P = 0.001, respectively). ROC curve analysis revealed that WT1 expression could differentiate between RCC with normal cytogenetics and non-severe AA. Based on a cut-off value of 1.45%, WT1 expression provided a sensitivity of 23.2% and a specificity of 100%.Discussion: In the present study, WT1 overexpression rate was gradually decreased in RAEB group, RCC group and AA subtypes, and the mean WT1 expression level of the MDS patients was significantly higher than that of the AA group. It is very difficult to differentiate between RCC with normal cytogenetics and NSAA in children. Our results showed significant differences in WT1 overexpression rate between these two groups. When we set the cut-off value as 1.45%, WT1 expression levels could be used to differentiate between cases of RCC with normal cytogenetics and NSAA in children.Conclusion: WT1 expression might be useful for distinguishing between myelodysplastic syndrome and aplastic anemia in children.

Intracellular Chloride Ion Channel Protein-1 Expression in Clear Cell Renal Cell Carcinoma.

Chloride intracellular channel 1 (CLIC1) represents a promising target for personalized therapy. Our aim was to assess CLIC1 expression in clear cell renal cell carcinoma (cc RCC) and identify its possible prognostic role. Fifty cases of cc RCC were evaluated and selected for immunohistochemistry. CLIC1 expression was correlated with tumor grade, invasion and heterogeneity. A total of 87.5% of the cases were CLIC1 positive, with either a homogeneous (31.42%) or a heterogeneous (68.57%) pattern. Low, mild and strong CLIC1 expressing tumors were defined based on nuclear (N), cytoplasmic (C), membrane (M) or combinations of them (NC, NM, CM, NCM) in terms of CLIC1 distribution. A significant correlation was found between tumor grade and percent of positive tumor cells (p=0.017). For G3 tumors, CLIC1 cytoplasmic expression was strongly correlated with high expression status (p=0.025) and tumor heterogeneity (p=0.004). CLIC1 expression was also correlated with metastasis (p=0.046). We defined four cc RCC groups depending on G, CLIC1 expression and pattern: i) G3/NM/low CLIC1+, ii) G2/CM/mild CLIC1+ iii) G1 or G2/NM or CM /high CLIC1+, and iv) G2/M /high CLIC1.

Right- and left-sided colon cancer - clinical and pathological differences of the disease entity in one organ.

IntroductionSome researchers suggest that cancers located in the right vs. the left side of the colon are different and they can be regarded as distinct disease entities. The aim of this study was to analyze differences in clinical, epidemiological and pathological features of patients with right-sided (RCC) and left-sided (LCC) colon cancer.Material and methodsOne thousand two hundred and twenty-four patients were operated on due to colorectal cancer. A group of 477 patients (254 women, mean age 65.5 ±11 for the whole group) with colon cancer was included (212 RCC vs. 265 LCC).ResultsRight colon cancer patients were older (67.8 ±11.3 vs. 63.2 ±11.2; p = 0.0087). Left colon cancer patients underwent surgery for urgent indications more often (17.0% vs. 8.5%; p = 0006). Tumor diameter was greater in the RCC group (55 ±60 mm vs. 38 ±21 mm; p = 0.0003). Total number of removed lymph nodes was higher in the RCC group (11.7 ±6 vs. 8.3 ±5; p = 0.0001). Lymph node ratio was higher in the LCC group (0.45 ±0.28 vs. 0.30 ±0.25; p = 0.0063). We found a strong positive correlation between tumor diameter and the number of removed lymph nodes in the LCC group (r = 0.531).ConclusionsThese differences may result from the fact that RCC patients are diagnosed at an older age. The smaller number of removed lymph nodes in LCC patients may result in incorrect staging. It is still necessary to find other biological dissimilarities of adenocarcinoma located on different sides of the colon.

Differential expression and clinical significance of serum protein among patients with clear-cell renal cell carcinoma

Looking for tumor markers by using protein chip technology is one of the hot topics, but many studies are still limited on short term detection of differential expressed proteins before and after surgery among patients with RCC. This study analyzed differential expressed serum protein and its clinical significance with clear-cell renal cell carcinoma to further measurement of the rule of variable expressing. Eighty-nine patients with clear-cell renal cell carcinoma who underwent surgery from November 2013 to 2014 and postoperatively confirmed by pathology were entered in RCC group, 100 healthy volunteers and patients without RCC who underwent medical examination in the same period were entered in control group. The serum protein were analyzed in both group before surgery and every regular follow-up period in 1 year after surgery with RCC group. The surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) and weak cation exchange protein chip (CM10) technology systems were used for identifying differential expressed serum protein in RCC group and controls. The linear support vector machine (SVM) was applied to establish the diagnostic model of protein fingerprints and the leave-one-out cross validation was used for determining model discriminating effect. The differential expressed proteins were analyzed by ZUCI-PDAS protein spectral data analysis system. Five kinds of proteins were identified as potential biomarker, ultimately. The M/Z of these proteins was 15953, 7987, 9304, 8948, 5911, respectively. There were significant difference on expression level of these proteins with two groups preoperatively (P< 0.05). Comparison of all postoperative expression levels to preoperative one and each differential level mutually between a year in postoperative period also revealed statistical significance (P< 0.05). With taking identified proteins as biomarker, the sensitivity and specificity in predicting clear-cell renal cell carcinoma was 88.8% (79/89) and 91.0% (91/100), respectively. The corresponding specific protein was Bcl-2 family apoptosis regulatory proteins, WAP four-disulfide core protein, Krueppel-like factor 8, monocyte chemotactic protein-1, serum amyloid β -protein-4, respectively, and will may serve as tumor markers of kidney cancer. These proteins manifests high predictive value for clear-cell renal cell carcinoma, and may contribute to therapeutic evaluation, prognosis and targeted therapy for clear-cell renal cell carcinoma.

MP45-15 A PROSPECTIVE ANALYSIS OF THE EFFECTS OF FOCAL THERAPY FOR PROSTATE CANCER ON ERECTILE FUNCTION FROM A COMBINED ANALYSIS OF 3 PROSPECTIVE TRIALS

rates to QOL surveys, as well as factors associated with response, in these two patient populations. METHODS: Patients who underwent surgery for RCC or PCa at our institution between 2006 and 2012 were offered enrollment in a prospective registry that included baseline and annual QoL assessment. We identified 201 patients in the RCC registry and 616 patients in the PCa registry who completed a baseline QoL survey and were mailed a follow-up QoL at one and two years post surgery [RCC: SF-36, FACTeG (73 questions), PCa: EPIC, IIEF, Max-PC (80 questions)]. We compared patient characteristics between responders (i.e. those that returned at least a one or two-year follow-up) and non-responders using a Wilcoxon rank-sum test for continuous variables and a Fisher’s Exact test for categorical variables. To compare cancer-specific survival (CSS) between responders and non-responders we employed Cox Proportional Hazards models. All statistical tests were two-sided, with significance set at p1⁄4 0.05. RESULTS: The overall response rate for the PCa and RCC groups were 63% and 48% (p<0.001), respectively. Interestingly, this difference in response rate remained when we limited analysis to only those with early stage disease (pT2a for PCa and pT1 RCC, 62% vs. 52%; p1⁄40.03). Among the PCa group, characteristics associated with response included older age (64.1 vs 62.6 years, p1⁄40.032) and robotic versus open surgery (56% vs 44%; p1⁄40.009). We observed no significant difference in CSS between PCa responders and non-responders. By comparison, we identified no characteristics that were associated with response in RCC group; however, non-responders had poorer CSS compared to responders. CONCLUSIONS: Surgically treated PCa patients have significantly higher QOL survey response rates than those patients with RCC. Societal awareness and education regarding RCC remains behind that of PCa, possibly due to the increased incidence of PCa, as well as an increase in men’s health awareness programs. The results may also indicate that patient’s expectations regarding surgery for RCC rely more heavily on survival, as opposed to PCa, where long-term quality of life continues to be a focus following surgery.

MP54-06 RADIOFREQUENCY ABLATION OUTCOMES BASED ON RENAL CELL CARCINOMA HISTOLOGIC SUBTYPES

You have accessJournal of UrologyKidney Cancer: Localized III1 Apr 2014MP54-06 RADIOFREQUENCY ABLATION OUTCOMES BASED ON RENAL CELL CARCINOMA HISTOLOGIC SUBTYPES Jeffrey Gahan, Gideon Lorber, Steve Faddegon, Raymond Leveillee, and Jeffrey Cadeddu Jeffrey GahanJeffrey Gahan More articles by this author , Gideon LorberGideon Lorber More articles by this author , Steve FaddegonSteve Faddegon More articles by this author , Raymond LeveilleeRaymond Leveillee More articles by this author , and Jeffrey CadedduJeffrey Cadeddu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1595AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Radiofrequency ablation (RFA) has been used as a successful modality for treating small renal masses in a minimally invasive, nephron sparing manner. Ablation failures are generally attributed to a vascular heat sink phenomenon. The vascularity, and thereby enhancement pattern, of RCC subtypes varies such that RFA success may be impacted. We sought to determine if outcomes for RFA ablation were significantly different based on RCC subtype. Methods All RFAs from two centers with extensive experience in performing RFA were reviewed. Only those with RCC subtype of clear cell or papillary RCC were included in the analysis. Other RCC subtypes (chromophobe n=8, oncocytic neoplasm n=9, mixed n=2) were each small and not included. RFA failure was defined as a >10 HU enhancement on contrast-enhanced CT in a previous zone of ablation. Disease-free survival (DFS) was defined as those patients who had no evidence of disease, either as initial ablation failures or as late recurrences. Groups where compared using the chi-squared or exact T test. The Kaplan-Meir method, using the log-rank test, was used to compare outcomes between RCC histologic subtypes. Results A total of 229 patients were included in the analysis. The mean age of the cohort was 64.5 +/- 13.8 years with a median follow-up of 48 (IQR 12-65) months. The mean tumor size of the cohort was 2.5 +/- 0.8 cm. There was no difference between the papillary and clear cell RCC groups based on age, tumor size or months of follow-up. A total of 181 (75.7%) tumors were clear cell type and 48 (20.1%) papillary type. There were 15 failures in the clear cell subtype and 0 in the papillary subtype, giving an estimated 5-year DFS of 89.7% and 100% for clear cell RCC and papillary RCC respectively (p=0.041). Conclusions This is the first report suggesting a significant difference in RFA success based in RCC subtype, with papillary RCC having more favorable outcomes compared to clear cell RCC. Based on this data, further studies looking at how best to follow RFA treated tumors based on subtype is warranted. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e574 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jeffrey Gahan More articles by this author Gideon Lorber More articles by this author Steve Faddegon More articles by this author Raymond Leveillee More articles by this author Jeffrey Cadeddu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...