Kidney Tumor Research Articles

Emerging Role of Hippo-YAP (Yes-Associated Protein)/TAZ (Transcriptional Coactivator with PDZ-Binding Motif) Pathway Dysregulation in Renal Cell Carcinoma Progression.

Although Hippo-YAP/TAZ pathway involvement has been extensively studied in the development of certain cancers, the involvement of this cascade in kidney cancer progression is not well-established and, therefore, will be the focus of this review. Renal cell carcinoma (RCC), the most prevalent kidney tumor subtype, has a poor prognosis and a high mortality rate. Core Hippo signaling inactivation (e.g., LATS kinases) leads to the nuclear translocation of YAP/TAZ where they bind to co-transcriptional factors such as TEAD promoting transcription of genes which initiates various fibrotic and neoplastic diseases. Loss of expression of LATS1/2 kinase and activation of YAP/TAZ correlates with poor survival in RCC patients. Renal-specific ablation of LATS1 in mice leads to the spontaneous development of several subtypes of RCC in a YAP/TAZ-dependent manner. Genetic and pharmacological inactivation of YAP/TAZ reverses the oncogenic potential in LATS1-deficient mice, highlighting the therapeutic benefit of network targeting in RCC. Here, we explore the unique upstream controls and downstream consequences of the Hippo-YAP/TAZ pathway deregulation in renal cancer. This review critically evaluates the current literature on the role of the Hippo pathway in RCC progression and highlights the recent scientific evidence designating YAP/TAZ as novel therapeutic targets against kidney cancer.

The application of mixed reality navigation system in laparoscopic partial nephrectomy for highly complex renal tumors (RENAL score ≥ 10): a retrospective cohort study.

The application of mixed reality navigation system in laparoscopic partial nephrectomy for highly complex renal tumors (RENAL score ≥ 10): a retrospective cohort study.

Multilocular cystic renal neoplasm: a rare tumor in kidney

Multilocular cystic renal cell carcinoma is a rare cystic tumour of kidney with excellent outcome. It is usually included in the group of tumours of undetermined malignant potential with low nuclear grade. We are presenting a case of 61 year. old female came with history of giddiness for 1 week and weight loss of 20 kg in 2 years. Imaging was suggestive of cortical based tumour arising from upper pole of right kidney. Right side partial nephrectomy was done. On histopathologic examination it was found to be MCRCC, stage 1 with Fuhrman nuclear grade 1. Immunohistochemistry with epithelial membrane antigen and cytokeratin-7 confirmed the diagnosis.

The predictive ability of Mayo adhesive probability score for evaluating intraoperative bleeding in standard percutaneous nephrolithotomy in adult patients.

Mayo adhesive probability (MAP) score is one of the commonest tool to predict the adherence status of perirenal fat. The association between MAP score and intraoperative hemorrhage in patients undergoing micropercutaneous nephrolithotomy was comfirmed in a recent well designed study. We aimed to investigate if MAP score may predict the possibility for significant intraoperative bleeding in supine percutaneous nephrolithotomy (PCNL) performed with a 26 Fr rigid nephroscope. In this observational retrospective study, demographic, clinical, laboratory, radiological, perioperative (operation duration, hospitalization, intraoperative bleeding, success) and MAP score (perinephric fat stranding, posterior perinephric fat thickness and total MAP score) data of all patients who underwent supine PCNL between June 2021 and July 2023 were evaluated. The patients were divided into 2 groups according to their MAP scores (79 [54.1%] patients with MAP score < 3 [low MAP score] and 67 [54.1%] patients with MAP score ≥ 3 [high MAP score]). The rate of patients with intraoperative bleeding was 47.8% in the patient group with a high MAP score, while it was 22.8% in the patient group with a low MAP score (p = 0.002). In multivariate logistic regression analysis, anticoagulant drug use history (OR = 2.525; 95% CI = 1.025-6.224; p = 0.044), presence of multiple stones (OR = 3.015; 95% CI = 1.205-7.543; p = 0.018), calyx localization of the stone (OR = 2.871;95% CI = 1.166-7.068; p = 0.022), higher renal parenchymal thickness (OR = 1.119; 95% CI = 1.049-1.193; p = 0.001) and MAP score > 3 (OR = 3.486; 95% CI = 1.579-7.696; p = 0.002) were defined as independent risk factors for significant intraoperative bleeding. In clinical practice, the MAP score can be used to predict bleeding before PCNL.

TGFBI promotes proliferation and epithelial–mesenchymal transition in renal cell carcinoma through PI3K/AKT/mTOR/HIF-1α pathway

BackgroundRenal cell carcinoma (RCC) is presently recognized as the most prevalent kidney tumor. However, the role and underlying mechanism of action of the conversion factor-inducible protein (TGFBI), an extracellular matrix protein, in RCC remain poorly understood.MethodsIn this study, we employed Western blot, quantitative real-time polymerase chain reaction (qRT-PCR), and immunohistochemistry techniques to assess the expression of TGFBI in RCC tissues or cells. Furthermore, we analyzed the proliferation and migration of RCC cells using CCK8, cloning, scratching, and migration assays. Additionally, we examined apoptosis and cell cycle progression through flow cytometry, analysis. Lastly, we employed gene set enrichment analysis (GSEA) to investigate the biological processes associated with TGFBI, which were subsequently validated.ResultsThe findings indicate that TGFBI exhibits significantly elevated expression levels in both renal cell carcinoma (RCC) tissues and cells. Furthermore, the knockdown of TGFBI in SiRNA transfected cells resulted in the inhibition of RCC cell proliferation, migration, invasiveness, apoptosis, and alteration of the cell cycle. Additionally, TGFBI was found to impede the epithelial-mesenchymal transition (EMT) process in RCC cells. Bioinformatics analysis suggests that TGFBI may exert its influence on various biological processes in RCC through the tumor immune microenvironment. Moreover, our study demonstrates that TGFBI promotes RCC progression by activating the PI3K/AKT/mTOR/HIF-1α.ConclusionsOur research indicates that TGFBI exhibits high expression in RCC and facilitate RCC progression and metastasis through various molecular mechanisms. Hence, TGFBI has the potential to be a novel therapeutic target for the diagnosis and treatment of RCC in the future.

Outcomes of type 1 versus type 2 papillary renal cell carcinoma following surgery: A 20-year experience

Introduction: Papillary renal cell carcinoma (PRCC) is the second most common type of renal cell carcinoma. Although studies have explored the connection between PRCC subtype and disease prognosis, the evidence is conflicting. We compared oncologic outcomes of type 1 and 2 PRCCs following surgical management. Methods: A single-centre, retrospective review identified patients undergoing surgery for PRCC from 2000 to 2022. Demographic, imaging, staging pathology, and follow-up data were collected. Recurrence-free, cancer-specific, and overall survival (RFS, CSS, OS) were calculated using the Kaplan-Meier method and Cox proportional hazard ratio. Results: A total of 249 patients were identified. Of the total, 177 patients had type 1 PRCC, and 72 had type 2. The average age was 62 years and was similar between groups ( p = 0.66). The median RENAL score was 7 for both groups ( p = 0.12). Type 2 had a higher pathologic T-stage with fewer pT1 (58% vs 86%) and more pT3 masses (32% vs 7%) than type 1 ( p &lt; 0.01). RFS, CSS, and OS were significantly worse in type 2 PRCC. However, this difference was not evident after adjusting for T-stage (Figure 1). Median follow-up duration was 16 months (interquartile range (IQR) 1–52). Conclusions: Type 2 PRCC is diagnosed at a higher stage than type 1. The difference between type 1 and 2 PRCC in RFS, OS, and CSS can be accounted for after correcting for staging. These findings suggest that surveillance and follow-up schedule for patients with papillary RCC should be based on pT-stage and not papillary subtype.

Tumor morphology evaluation using 3D-morphometric features of renal masses.

To assess the correlation between the general (gender, age, and maximum tumor size) and 3D morphotopometric features of the renal tumor node, following the MSCT data post-processing, and the tumor histological structure; to propose an equation allowing for kidney malignancy assessment based on general and morphometric features. In total, 304 patients with unilateral solitary renal neoplasms underwent laparoscopic (retroperitoneoscopic) or robotic partial or radical nephrectomy. Before the procedure, kidney contrast-enhanced MSCT followed by the tumor 3D-modeling was performed. 3D model of the kidney tumor, and its morphotopometric features, and histological structure were analyzed. The morphotopometric ones include the side of the lesion, location by segments, the surface where the tumor, the depth of the tumor invasion into the kidney, and the shape of tumor. Out of 304 patients, 254 (83.6%) had malignant kidney tumors and 50 (16.4%) benign kidney tumors. In total, 231 patients, out of 254 (90.9%) were assessed for the degree of malignant tumor differentiation. Malignant tumors were more frequent in men than in women (p < 0.001). Mushroom-shaped tumors were the most common shapes among benign renal masses (35.2%). The most common malignant kidney tumors had spherical with a partially uneven surface (27.6%), multinodular (tuberous (27.2%)), and spherical with a conical base (24.8%) shapes. Logistic regression model enabled the development of prognostic equation for tumor malignancy prediction ("low" or "high"). The univariate analysis revealed the correlation only between high differentiation (G1) and a spherical tumor with a conical base (p = 0.029). The resulting logistic model, based on the analysis of such predictors as gender and form of kidney lesions, demonstrated a large share (87.6%) of correct predictions of the kidney tumor malignancy.

Wilms Tumor with Vena Caval Intravascular Extension: A Surgical Perspective.

Wilms tumor (WT) is the most common kidney tumor in pediatric patients. Intravascular extension of WT above the level of the renal veins is a rare manifestation that complicates surgical management. Patients with intravascular extension are frequently asymptomatic at diagnosis, and tumor thrombus extension is usually diagnosed by imaging. Neoadjuvant chemotherapy is indicated for thrombus extension above the level of the hepatic veins and often leads to thrombus regression, obviating the need for cardiopulmonary bypass in cases of cardiac thrombus at diagnosis. In cases of tumor extension to the retrohepatic cava, neoadjuvant therapy is not strictly indicated, but it may facilitate the regression of tumor thrombi, making resection safer. Hepatic vascular isolation and cardiopulmonary bypass increase the risk of bleeding and other complications when utilized for tumor thrombectomy. Fortunately, WT patients with vena caval with or with intracardiac extension have similar overall and event-free survival when compared to patients with WT without intravascular extension when thrombectomy is successfully performed. Still, patients with metastatic disease at presentation or unfavorable histology suffer relatively poor outcomes. Dedicated pediatric surgical oncology and pediatric cardiothoracic surgery teams, in conjunction with multimodal therapy directed by a multidisciplinary team, are preferred for optimized outcomes in this patient population.

The effect of adipose-derived stem cells (ADSC) treatment on kidney histopathological appearance on the Wistar rat models with grade five kidney trauma.

Kidney trauma is the most common urological trauma. Technological advances have made conservative management possible for almost all kidney trauma. However, grade five kidney trauma needs to be carefully examined dueto its various complications, especially late complications that often delayed in recognition thus forming irreversible morbidity, with the most common late complication is kidney damage due to ischemic and fibrotic process. This study aims to confirm the effect of Adipose-Derived Stem Cells (ADSC) onthe prevention of fibrosis in grade five kidney trauma using Wistar rat models, where the fibrosis process will be measured with histopathological examination which had features of glomerular sclerosis, tubular atrophy, and interstitial fibrosis in kidney tissue, then followed by histopathological scoring and total renal score. A total of 22 adult rats were divided into five groups: one healthy control group, two trauma groups without ADSC, and two others trauma groups with ADSC. Two different treatment times were set: two weeks and four weeks after treatment. The data were tested for normality (Shapiro-Wilk test), while differences between groups were assessed using one-way ANOVA or Kruskal-Wallis test if the distribution was not normal. For the result of total renal score, statistical analysis reveal a significant difference in the total renal score in the kidney trauma with ADSC group compared with kidney trauma without ADSC group in fourth week of observation (p=0.001). These findings highlighted ADSC capability toprevent fibrosis caused by grade five kidney trauma on the Wistar rat models, as proven by significantly reduced histopathological grading on fibrosis.

Pan‑cancer analysis on the role of KMT2C expression in tumor progression and immunotherapy.

Histone lysine N-methyltransferase 2C (KMT2C) is involved in transcriptional regulation and DNA damage repair. Mutations in KMT2C have been implicated in the progression, metastasis, and drug resistance of multiple cancer types. However, the roles of KMT2C in the regulation of tumor prognosis, immune cell infiltration and the immune microenvironment in these multiple cancer types remain unclear. Therefore, in the present study, data from The Cancer Genome Atlas and Genotype-Tissue Expression databases were used for KMT2C expression analyses. Kaplan-Meier and univariate Cox regression analyses were also performed to investigate the prognostic role of KMT2C. In addition, Gene Set Enrichment Analysis (GSEA) was conducted to study the KMT2C-related signaling pathways. Tumor immune estimation resource 2 and single-sample GSEA were conducted to investigate the correlation between KMT2C expression and immune cell infiltrations, and Spearman's analysis was conducted to study the correlations among KMT2C, tumor mutational burden, microsatellite instability, immune regulators, chemokines and immune receptors. Immunohistochemistry of patient kidney tumor samples was performed to verify the correlation between KMT2C and programmed death-ligand 1 (PD-L1) expression. Finally, RNA interference, wound healing and colony formation assays were conducted to evaluate the effects of KMT2C expression on cell proliferation and metastasis. The results of the present study demonstrated that KMT2C was highly expressed in multiple cancer types, was a protective factor in kidney renal clear cell carcinoma and ovarian serous cystadenocarcinoma, and a risk factor for lung squamous cell carcinoma and uveal melanoma. In addition, KMT2C levels were negatively correlated with immune-activated pathways and the infiltration of immune cells, and positively correlated with inhibitory immune factors and tumor angiogenesis. Patients with low KMT2C expression had higher objective response rates to immunotherapy, and drug sensitivity analysis indicated that topoisomerase, histone deacetylase, DOT1-like histone H3K79 methyltransferase and G9A nuclear histone lysine methyltransferase inhibitors could potentially be used to treat tumors with high KMT2C expression levels. Finally, the KMT2C and PD-L1 expression levels were shown to be positively correlated, and KMT2C knockdown markedly promoted the proliferation and invasion capacities of A549 cells. In conclusion, the present study revealed that low KMT2C expression may be a promising biomarker for predicting the response of patients with cancer to immunotherapy. Conversely, high KMT2C expression was shown to promote tumor angiogenesis, which may contribute to the formation of the immunosuppressive tumor microenvironment.

Mutagenicity evaluation of methyl tertiary- butyl ether in multiple tissues of transgenic rats following whole body inhalation exposure.

Methyl tertiary-butyl ether (MTBE) is used as a component of motor vehicle fuel to enhance combustion efficiency and to reduce emissions of carbon monoxide and nitrogen oxides. Although MTBE was largely negative in the in vitro and in vivo genotoxicity studies, isolated reports of positive findings along with the observation of tumors in the rat cancer bioassays raised concern for its in vivo mutagenic potential. To investigate this, transgenic male Big Blue Fischer 344 rats were exposed to 0 (negative control), 400, 1000, and 3000 ppm MTBE via whole body inhalation for 28 consecutive days, 6 h/day. Mutant frequencies (MF) at the cII locus of the transgene in the nasal epithelium (portal of entry tissue), liver (site of primary metabolism), bone marrow (rapidly proliferating tissue), and kidney (tumor target) were analyzed (5 rats/exposure group) following a 3-day post-exposure manifestation period. MTBE did not induce a mutagenic response in any of the tissues investigated. The adequacy of the experimental conditions to detect induced mutations was confirmed by utilizing tissue samples from animals treated with the known mutagen ethyl nitrosourea. These data provide support to the conclusion that MTBE is not an in vivo mutagen and male rat kidney tumors are not likely the result of a mutagenic mode of action.

BCOR overexpression in pediatric sarcomas- a morphologic continuum of mixed round and spindle cell tumors

Objectives The vast majority of BCOR (BCL6 corepressor) sarcomas occur in the pediatric population and include different clinico-pathologic entities. This study evaluates morphology, immunohistochemistry and clinical outcome in pediatric BCOR sarcomas. Material and Methods Children, aged ≤ 18yrs, diagnosed to have translocation negative Ewing-like sarcoma, clear cell sarcoma of the kidney and primitive myxoid mesenchymal tumor of infancy, over a period of five years were included. Immunohistochemical staining for BCOR antibody was done and the cases with BCOR overexpression were subjected to a further immunopanel comprising of special AT-rich sequence-binding protein 2 (SATB2), Transducin-Like enhancer of split-1 (TLE1), Cyclin D1 and NKX2.2. The clinical outcome of patients with BCOR overexpression was assessed. Results BCOR overexpression was seen in 16/42 cases; Five were primary soft tissue tumors, three were primary bone tumors, seven were clear cell sarcoma of the kidney and one primary renal sarcoma. The median age of this group was 3.5 years (range 2–18 years) with male predominance (75%). All the BCOR positive tumors showed statistically significant morphological and immunohistochemical overlap. 4/16 did not take treatment at our center. Of the 12 who received treatment, 8 are in Complete Remission 1 (CR1). The mean event-free survival (EFS) and overall survival (OS) were 51.89 months (95% CI: 37.36-66.42) and 62.08 months (95% confidence interval (CI): 52.85-71.30) respectively. Conclusion BCOR sarcomas did not show any statistically significant histological and immunohistochemical differences, thus reiterating the morphologic continuum of these clinically distinct tumors.

BFT‐Net: A transformer‐based boundary feedback network for kidney tumour segmentation

AbstractKidney tumours are among the top ten most common tumours, the automatic segmentation of medical images can help locate tumour locations. However, the segmentation of kidney tumour images still faces several challenges: firstly, there is a lack of renal tumour endoscopic datasets and no segmentation techniques for renal tumour endoscopic images; secondly, the intra‐class inconsistency of tumours caused by variations in size, location, and shape of renal tumours; thirdly, difficulty in semantic fusion during decoding; and finally, the issue of boundary blurring in the localization of lesions. To address the aforementioned issues, a new dataset called Re‐TMRS is proposed, and for this dataset, the transformer‐based boundary feedback network for kidney tumour segmentation (BFT‐Net) is proposed. This network incorporates an adaptive context extract module (ACE) to emphasize local contextual information, reduces the semantic gap through the mixed feature capture module (MFC), and ultimately improves boundary extraction capability through end‐to‐end optimization learning in the boundary assist module (BA). Through numerous experiments, it is demonstrated that the proposed model exhibits excellent segmentation ability and generalization performance. The mDice and mIoU on the Re‐TMRS dataset reach 91.1% and 91.8%, respectively.

Extraskeletal osteosarcoma infiltrating pancreas, spleen, gastric, and left kidney: a case report

BackgroundExtraskeletal osteosarcoma is an extremely rare malignancy that accounts for 1% of soft tissue sarcoma and 4.3% of all osteosarcoma. Extraskeletal osteosarcoma can develop in a patient between the ages of 48 and 60 years. The incidence of extraskeletal osteosarcoma is slightly higher in male patients than in females.Case presentationA 50-year-old Caucasian male patient presented with a 6-month history of intermittent lower-left back pain that limits his activity. Prior ultrasonography and abdominal computed tomography scan showed a diagnosis of kidney stone and tumor in the lower-left abdomen. The computed tomography urography with contrast revealed a mass suspected as a left retroperitoneal malignant tumor. Hence, the tumor was resected through laparotomy and the patient continued with histopathological and immunohistochemistry examination with the result of extraskeletal osteosarcoma.ConclusionExtraskeletal osteosarcoma presents diagnostic challenges requiring multimodal examination, including histological and immunohistochemistry analyses. This case underscores the aggressive nature and poor prognosis despite undergoing the current suggested treatment.

Increasing abdominal circumference in children – does it require diagnosis?

Introduction and purpose: Wilms tumor, also known as nephroblastoma, is the most prevalent malignant tumor of the kidney in the pediatric population. 90% of them are diagnosed in children before the age of 6. This tumor is more common in girls, and usually occurs unilaterally. The purpose of the study is to analyse and present the incidence of the patients with Wilms tumor in University Children’s Hospital in Lublin in comparison to other studies published on PubMed. Material and methods: The study included 34 patients with the Wilms tumor in the past medical history. They were selected among patients who had a computed tomography (CT) scan in the Department of Pediatric Radiology between November 2012 and October 2021. Results: The average diagnostic age of Wilms tumor patients was 3 years and 9 months. The unilateral occurrence of the tumor was more common, also, the presence of a tumor in the left kidney was more frequent than in the right one. Metastases were mainly located in the lungs and liver. The less common sites of metastasis were pleural recesses and paraaortic lymph nodes. Treatment was mostly based on nephrectomy and chemotherapy, and less frequently, on radiotherapy. In the majority of patients, treatment resulted in regression of cancer lesions. Only a few recurrences of the disease were reported. Conclusions: Successful treatment protocols for Wilms tumor (pre-operative chemotherapy and surgery) ensure a high survival rate. It is important to monitor the patient after treatment due to the risk of recurrence. During diagnostics, chest and abdominal CT should be considered because of the high incidence rate of lung and liver metastases.

399 Cancer Recurrence in Positive Margin Partial Nephrectomies: 5-Year Results from the West of Scotland

Abstract Aim Provide insight into the incidence of disease recurrence following a positive margin partial nephrectomy in Renal cancer patients. Allowing the analysis of the current surveillance protocols for early detection of disease recurrence. Method A retrospective review of all patients undergoing Partial Nephrectomies (PN) within a single centre between 2016 and 2021 was performed. Demographic data including age and sex, as well as tumour-specific data of histology, RENAL score, tumour margin, surveillance, and disease recurrence was recorded. Follow-up was performed as per WOSCAN guidance. Results 255 patients underwent PN: 79 (31%) open (OPN) and 176 (69%) robotic-assisted procedures (RALPN). OPN was performed in higher risk cancers with a higher risk of positive margin compared to RALPN (10.1% vs 6.25%). The median follow-up time was 35 months. 3 patients with positive margins had recurrence; all were pT3 cancer following OPN of which 2 had metastatic and 1 patient had local recurrence. 18 positive margin patients (95%) were compliant with WOSCAN surveillance guidelines. Conclusions OPN was performed for more complex tumours which had a higher risk of positive margins and thus recurrence. Regional data can be used to better counsel patients, however further work should assess any evolving change in RALPN positive margin rates as more complex tumours are attempted robotically.

Prognostic factors and outcomes in anti-neutrophil cytoplasmic antibody-associated glomerulonephritis: A retrospective single-center study from southern China.

To investigate the prognostic factors and outcomes in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) in Southern China. A retrospective analysis of medical records of patients with ANCA-GN admitted to Shenzhen Hospital of Southern Medical University and Nanfang Hospital of Southern Medical University between September 2011 and September 2021 was performed. The clinical presentation, biological, and renal pathology were collected. In addition, the risk factors for end-stage renal disease (ESRD) and short-term overall survival in patients with ANCA-GN were analyzed. A total of 93 patients with ANCA-GN were included in the study. Of them, 91.4%, were perinuclear anti-neutrophil cytoplasmic antibodies (MPO-pANCA)-positive. Approximately one-quarter (24.7%) of patients had progressed to ESRD, and 7.5% died within six months. Most patients presented with hematuria (94.6%), proteinuria (78.5%), elevated serum creatinine (86.0%), anemia (90.3%), and increased erythrocyte sedimentation rate (ESR) (44.1%). The majority (94.6%) of patients presented with crescent formations at histopathological examination. Serum creatinine, hemoglobin, and Birmingham vasculitis activity score (BVAS) were all independent factors for ESRD (P<0.05). Moreover, while ANCA renal risk score (ARRS) has an impact on prognosis of nephropathy, it did not influence ESRD independently (P>0.05). The effect of Berden's histopathologic classification on ESRD has not been confirmed. Age at onset, ESR and cardiovascular involvement were all independent factors affecting short-term overall survival of patients with ANCA-GN (P<0.05). Serum creatinine, hemoglobin, and BVAS were all independent risk factors of ESRD, while ARRS and Berden's histopathologic classification were not. Age at onset, ESR, and cardiovascular involvement were independent risk factors for the overall six-month survival rate in patients with ANCA-GN.

Impact of Socioeconomic Status on Patient Adherence in Managing Renal Masses.

Previous literature suggests socioeconomic status and racial disparities impact management decisions for patients with small renal masses. We aim to build upon these findings and examine how these modalities impact patient adherence to their management plan. This retrospective study analyzed our Kidney Tumor Program database (n = 1476) containing patients from 2000 to 2020. Socioeconomic status was estimated using 2 modalities: Area Deprivation Index and household income. Patients were then evaluated for differences in adherence, nonadherence, and loss to follow-up. Adherent patients completed all recommended appointments within 6 months of their initial follow-up. Nonadherent patients did not complete all recommended appointments within 6 months of their originally scheduled follow-up but eventually did. Patients lost to follow-up were recommended to follow up but never did. Patient adherence was not significantly different across sex or primary treatment method but differed with respect to race/ethnicity. Black patients were significantly more likely to be nonadherent (P = .021) and lost to follow-up (P = .008). After adjusting for race/ethnicity, Area Deprivation Index and income bracket were significantly associated with adherence and loss to follow-up. Patients with a high socioeconomic status had significantly higher rates of adherence (ADI, quartile [Q] 1 vs Q4, P = .038; income, >$120,000 vs $30,000-$59,999, P < .003) and decreased loss to follow-up (ADI, Q1 vs Q4, P = .03; income, >$120,000 vs $30,000-$59,999, P = .002). Our results demonstrate that Black race and low socioeconomic status are associated with decreased adherence and increased loss to follow-up. Possible strategies to target these disparities include financial assistance programming, social determinants of health screening, and nurse navigator programs.

Overexpression of glyoxalase system enzymes in human kidney tumor: Erratum.

Overexpression of glyoxalase system enzymes in human kidney tumor: Erratum.

The impact of sestamibi scan on clinical decision-making for renal masses: An observational single-center study.

We aimed to determine whether sestamibi scan changes management of renal masses. All patients undergoing sestamibi scan for renal masses between 2008 and 2022 at a single center were retrospectively reviewed. Data were gathered on patient demographics, pre- and postoperative creatinine, sestamibi scan parameters, and cross-sectional imaging characteristics. Outcomes included whether the patient underwent renal mass biopsy or surgical resection and the final pathological diagnosis if tissue was obtained from biopsy or resection. Data regarding postbiopsy as well as postoperative complications were also collected. The odds ratio (OR) for surgery or biopsy based on sestamibi result was calculated. Forty-three patients underwent sestamibi scan from 2008 to 2022, with 10 scans consistent with oncocytoma and 33 with nononcocytoma. The mean tumor size at initial presentation was 4.0 ± 1.8 cm with a median RENAL score of 7 (range: 4-11). For patients with sestamibi scans negative for oncocytoma, the OR for surgery was 12.5 (95% confidence interval [CI]: 2.1-71.2, P = 0.005), and the OR for biopsy was 0.04 (95% CI: 0.005-0.39, P = 0.005). Conversely, for patients with sestamibi scans positive for oncocytoma, the OR for surgery was 0.28 (95% CI: 0.03-2.4, P = 0.24) and the OR for biopsy was 24.0 (95% CI: 2.6-222.7, P = 0.005). Creatinine at the last follow-up was similar between patients with positive and negative sestamibi scans. No patients experienced complications from surgery or biopsy. The median follow-up was 19 months (range: 2-163). A sestamibi scan positive for oncocytoma led to increased use of renal mass biopsy for confirmation. Sestamibi scans that were negative for oncocytoma were more likely to result in surgical resection without biopsy.