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Objective A prospective, observational, post-marketing surveillance was conducted to assess the safety and effectiveness of temsirolimus in patients with renal cell carcinoma in Japan. Methods Patients prescribed temsirolimus for advanced renal cell carcinoma were registered and received temsirolimus (25 mg weekly, intravenous infusion for 30–60 minutes) in routine clinical settings (observation period: 96 weeks). Results Among 1001 patients included in the safety analysis data set (median age, 65.0 years; men, 74.8%; Eastern Cooperative Oncology Group performance status 0 or 1, 69.6%), 778 (77.7%) reported adverse drug reactions. The most common (≥10%) all-grade adverse drug reactions were stomatitis (26.7%), interstitial lung disease (17.3%) and platelet count decreased (11.1%). The incidence rate of grade ≥3 interstitial lung disease was 4.5%. The onset of interstitial lung disease was more frequent after 4–8 weeks of treatment or in patients with lower Eastern Cooperative Oncology Group performance status (21.6% for score 0 vs 8.3% for score 4, P, In this Japanese post-marketing surveillance study, the safety and effectiveness profile of temsirolimus was similar to that in the multinational phase 3 study. No new safety signals were identified.

Purpose To evaluate the significance of preoperative and follow-up neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors for recurrence in patients with non-metastatic clear cell renal cell carcinoma (NMCCRCC). Materials and methods We retrospectively reviewed the medical records of 309 patients with NMCCRCC who underwent radical or partial nephrectomy. The prognostic significance of various clinicopathological variables, preoperative NLR (pNLR) and PLR (pPLR), and NLR and PLR at recurrence or quasi-recurrence (rNLR and rPLR) for recurrence-free survival (RFS) was analyzed. Results At mean follow-up of 93 months, 44 patients (14.2%) developed recurrence. In the univariate analysis, clinical presentation, tumor size, pathologic tumor stage, Fuhrman grade, pNLR, pPLR and rNLR were significant prognostic factors for RFS. In the multivariate analysis using pNLR and pPLR as continuous variables, tumor size, pathologic tumor stage and pPLR were independent prognostic factors for RFS. In the multivariate analysis using pNLR and pPLR as dichotomous variables, tumor size, pathologic tumor stage, Fuhrman grade and pNLR ≥1.7 were independent prognostic factors for RFS. In multivariate analyses using rNLR and rPLR, only tumor size and pathologic tumor stage were independent prognostic factors for RFS. In a subset of patients with recurrence or at least 42 months follow-up without recurrence, rNLR ≥1.9 was significantly associated with worse RFS, albeit without independent significance. Conclusions pNLR and pPLR are independent prognostic factors for RFS in patients with NMCCRCC. We propose that postoperative follow-up NLR of 1.9 and higher with one or more adverse clinicopathological factors should prompt radiologic evaluation for possible metastasis.

WOS: 000513496500002 PubMed: 31823081 We aim to investigate the prognostic significance of the hemoglobin X lymphocyte / neutrophil ratio (HLNR) and hemoglobin x lymphocyte / platelet ratio (HLPR) with tumor aggressivity in patients with renal cell carcinoma. We retrospectively analyzed 127 patients' data who had diagnosed as renal cell carcinoma between 2008 and 2019 in Suleyman Demirel University Hospital. Tumor and patient characteristics, hemoglobin, neutrophil, lymphocyte, platelet values HLNR and HLPR were calculated in preoperative hemogram parameters. The relationship between tumor pathological stage, Fuhrman nuclear grade and tumor necrosis with HLPR and HLNR analyzed with statistically. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLNR. P values are 0.003, 0.012 and 0.015 respectively. HLNR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLPR. P values are 0.001, 0.014 and 0.047 respectively. HLPR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. High pathological stage, high Fuhrman nuclear grade and existence of tumor necrosis are associates with preoperative low HLNR and low HLPR in renal cell carcinoma patients. They can be used as prognostic markers in patients with renal mass preoperatively.

ResumenObjetivoDiferenciar el angiomiolipoma atípico del carcinoma de células renales del mismo tamaño mediante hallazgos tomográficos.Materiales y métodosSe realizó un estudio retrospectivo con 68 pacientes (17 con angiomiolipomas atípicos y 51 con carcinoma de células renales) nefrectomizados por diagnóstico presuntivo preoperatorio, mediante tomografía computada trifásica (fases sin contraste, corticomedular y excretora temprana), de carcinoma de células renales menor de 45mm. Dos radiólogos que desconocían el diagnóstico definitivo evaluaron retrospectivamente las características generales del tumor, su atenuación en fase sin contraste y las características de su realce. Se realizó un análisis estadístico con software R, aplicándose el modelo logit para diferenciar el angiomiolipoma atípico del carcinoma de células renales a partir de los hallazgos tomográficos de masa renal, incluidos en el modelo final el contorno, la atenuación en fase sin contraste y el patrón de realce con el tiempo.ResultadosLos hallazgos de angiomiolipoma atípico que resultaron significativos fueron atenuación tumoral en fase sin contraste hiperdensa y patrón de realce con tiempo prolongado con chance de ocurrencia de 10,49 (p=0,0381) y 36,71 (p=0,0009), respectivamente. En los pacientes, según el valor de cada hallazgo incluido en el modelo, se calculó probabilidad, sensibilidad (0,2941) y especificidad (0,9804). La curva característica operativa del receptor (ROC) determinó un punto de corte óptimo (0,9694) para discriminar el angiomiolipoma atípico, por lo que se confirmó su presencia.ConclusiónLa tomografía computada helicoidal trifásica es útil para diferenciar el angiomiolipoma atípico del carcinoma de células renales, siendo la atenuación hiperdensa sin contraste del tumor y su patrón de realce prolongado los hallazgos tomográficos más valiosos.SummaryObjectiveTo compare various computed tomographic features of atypical angiomyolipoma with those of size-matched renal cell carcinoma.Materials and methodsSixty-eight patients (17 with atypical angiomyolipomas and 51 with carcinoma renal cells) who had undergone nephrectomy by presumptive diagnosis of carcinoma renal cell

Purpose: Renal cell carcinoma is a heterogeneous kidney cancer, and over 403,000 cases were reported worldwide in 2018. Current methods for studying renal cell carcinoma are limited to two-dimensional (2D) culture of primary cell lines and patient-derived xenograft models. Numerous studies have suggested that 2D culture poorly represents the diversity, heterogeneity, and drug-resistance of primary tumors. The time and cost associated with patient-derived xenograft models poses a realistic barrier to their clinical utility. As a biomimetic model, patient-derived three-dimensional (3D) organoid culture can overcome these disadvantages and bridge the gap between in vitro cell culture and in vivo patient-derived xenograft models. Here, we establish a patient-derived 3D organoid culture system for clear cell renal cell carcinoma and demonstrate the biomimetic characteristics of our model with respect to both primary kidney cancer and conventional 2D culture. Materials and Methods: Normal renal tissues and tumor tissues were collected from patients with clear cell renal cell carcinoma. The dissociated cells were cultured as conventional 2D culture and 3D organoid culture. The biomimetic characteristic of the two cultures were compared. Results: Compared with 2D culture, the 3D organoid cultures retained the characteristic lipid-rich, clear cell morphology of clear cell renal cell carcinoma. Carbonic anhydrase 9 and vimentin were validated as biomarkers of renal cell carcinoma. Expression of the two validated biomarkers was more enhanced in 3D organoid culture. Conclusions: Patient-derived 3D organoid culture retains the characteristics of renal cell carcinoma with respect to morphology and biomarker expression.

Purpose: This study aimed to compare progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) in Heng intermediate-risk patients with metastatic renal cell carcinoma (mRCC) treated with first-line immunotherapy (IT) or targeted therapy (TT). Materials and Methods: From 2000 to 2017, a total of 186 intermediate-risk mRCC patients treated with first-line IT (n=64, 34.4%) or TT (n=122, 65.6%) were retrospectively evaluated for PFS, OS, and CSS using the Kaplan–Meier method with log-rank test and Cox proportional hazards models for their risk factors with a p-value for significance of

Although renal collecting system invasion is not considered in the current TNM staging system, this finding may be relevant in terms of treatment planning and prognosis. The objective of this study was to investigate the frequency of collecting system invasion in renal cell carcinoma (RCC) and to assess the diagnostic performance of excretory phase CT for the assessment of collecting system invasion.We conducted a retrospective study of 261 patients (171 men and 90 women; average age, 61 years; age range, 32-86 years) who underwent CT before nephrectomy for RCC between November 2008 and July 2011 at a single institution. On excretory phase contrast-enhanced CT images, two radiologists independently determined whether RCC components caused a filling defect within the collecting system and whether the RCC was in contact to the collecting system wall or separated from it. Histopathology served as the standard of reference. Interreader agreement and diagnostic performance tests for the detection of collecting system invasion were calculated.Histopathology identified collecting system invasion exclusively in clear cell RCC that showed a filling defect within the collecting system on excretory phase CT images (5.4%, 14/261). Tumors separated from or in contact with the collecting system on imaging (both readers; 94.6%, 247/261) did not show collecting system invasion on histopathology (sensitivity, 100%; specificity, 100%). Interreader agreement was excellent (κ, 0.965; 95% CI, 0.93-0.99).CT provides reliable assessment of collecting system invasion in patients with RCC, with excellent sensitivity and specificity.

PURPOSE To assess diagnostic performance and interreader agreement of tumor to sinus distance measurements and visual assessment of renal sinus fat invasion at T2 weighted magnetic resonance (MR) imaging as predictors of muscular venous branch invasion (MVBI) in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS The institutional review board approved this retrospective study and waived the informed consent requirement. The study was HIPAA compliant. A total of 186 consecutive patients underwent preoperative 1.5 T MR imaging; 188 RCCs were identified. Blinded to histopathologic information two readers independently measured the tumor to sinus distance and assessed renal sinus fat invasion on transverse and coronal T2 weighted MR images. Interreader agreement (intraclass correlation coefficient Cohen ?) and performance characteristics of imaging tests were calculated. Histopathologic findings served as the standard of reference. RESULTS Histopathologic findings indicated MVBI in 35 (66 of 188) of tumors. At imaging all tumors with MVBI had a tumor to sinus distance of 0 mm. All tumors with renal sinus fat invasion at imaging had MVBI. Sensitivity and specificity for the detection of renal sinus fat invasion were 100 (95 confidence interval [CI]: 92 100) and 94 (95 CI: 89 98). In the absence of renal sinus fat invasion at imaging a tumor to sinus distance of 0 mm was associated with MVBI in 21 (18 of 86) of cases. Interreader agreement for quantitative (intraclass correlation coefficient = 0.92; 95 CI: 0.89 0.94) and qualitative (? = 0.89; 95 CI: 0.81 0.96) assessments was excellent. CONCLUSION Tumor to sinus distance measurements and the assessment of renal sinus fat invasion at T2 weighted MR imaging can be used reliably to rule out MVBI in patients with RCC.

OBJETIVOS: Pacientes com carcinoma de células renais (CCR) quando diagnosticados precocemente têm maior possibilidade de cura com o tratamento cirúrgico. Este estudo tem como objetivo analisar as características anatomopatológicas dos espécimes cirúrgicos que justificam a diferença da história natural dos pacientes com CCR incidental e sintomático. MÉTODOS: Foram estudados retrospectivamente 115 pacientes submetidos a nefrectomia por CCR esporádico, divididos em Grupo 1: 59 pacientes assintomáticos com diagnóstico incidental e Grupo 2: 56 pacientes sintomáticos. A média de idade dos pacientes foi de 59 anos, com 86 homens e 29 mulheres. Cirurgia radical foi realizada em 96 pacientes e cirurgia conservadora em 19 casos. Foram analisadas as características anatomopatológicas, incluindo grau nuclear, estadio patológico, tamanho do tumor e presença de invasão microvascular intratumoral, sendo estes parâmetros comparados com a sobrevida dos pacientes. RESULTADOS: Ao compararmos os dois grupos, confirmou-se que os tumores incidentais têm menor grau nuclear (p=0,003), menor tamanho (p=0,001), menor incidência de invasão microvascular (p