Histologic subtype needs to be considered after partial nephrectomy in patients with pathologic T1a renal cell carcinoma: papillary vs. clear cell renal cell carcinoma

2017 ◽  
Vol 143 (9) ◽  
pp. 1845-1851 ◽  
Author(s):  
Sangjun Yoo ◽  
Dalsan You ◽  
In Gab Jeong ◽  
Cheryn Song ◽  
Bumsik Hong ◽  
...  
2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 548-548 ◽  
Author(s):  
Rana R. McKay ◽  
Bradley Alexander McGregor ◽  
Kathryn Gray ◽  
John A. Steinharter ◽  
Meghara K. Walsh ◽  
...  

548 Background: NccRCC and sccRCC have historically been underrepresented in clinical trials. Even with targeted therapy, most patients have inferior survival compared to clear cell renal cell carcinoma. The combination of atezolizumab and bevacizumab has demonstrated safety and efficacy in ccRCC. In this multicenter, phase II, open-label, single arm trial we evaluate the efficacy of atezolizumab and bevacizumab in patients with nccRCC and sccRCC with >20% sarcomatoid differentiation. Methods: Eligible patients had an ECOG performance status of 0-2 and may have received prior therapy. Prior PD-1/PD-L1 therapy was not allowed. Patients underwent a mandatory baseline biopsy and subsequently received atezolizumab 120 mg and bevacizumab 15 mg/kg intravenously every 3 weeks. Patients remained on therapy until radiographic progression, unacceptable adverse events, or withdrawal. The primary end point was overall response rate (ORR) as determined by RECIST version 1.1. Results: 65 patients were enrolled of whom 52 had ≥1 response assessment and were included in this analysis. 36 patients had nccRCC (papillary n=14, chromophobe n=8, unclassified RCC n=3, collecting duct n=3, translocation n=3, other n=5), and 16 patients had sccRCC. 17 patients received prior systemic therapy, 16 of whom had nccRCC. The ORR was 31% in the overall cohort (Table 1). 10 patients (19%) developed grade 3 treatment-related adverse events (AEs), half of which were immune-related. There were no grade 4-5 AEs. Conclusions: In this study, we show that therapy with atezolizumab and bevacizumab was safe and demonstrated anti-tumor activity in nccRCC and sccRCC. Further analyses will report ORR by histologic subtype and PD-L1 expression status. Analysis of tissue and blood-based biomarkers of response are ongoing. Clinical trial information: NCT02724878. [Table: see text]


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S61-S61
Author(s):  
S Arora ◽  
C G Rogers ◽  
K Arora ◽  
R Abou Shaar ◽  
B Kezlarian ◽  
...  

Abstract Introduction/Objective Renal mass biopsy is known to have a low but unavoidable diagnostic error rate. However, the occurrence of multiple adjacent masses mimicking one mass clinically has been minimally studied. Methods We report a series of four patients who were radiologically presumed to have a single renal mass and treated with partial nephrectomy, yet who were found to have multiple demarcated renal cell carcinoma histologies at pathologic evaluation. Results All were men aged 63–70 years. Grossly, tumors were red brown with scant, bright yellow foci in one of them. Dominant tumors followed by smaller tumors were: patient 1 - clear cell renal cell carcinoma (5.0 cm), clear cell papillary renal cell carcinoma (0.5 cm), and papillary adenoma (0.6 cm); patient 2 - clear cell renal cell carcinoma (1.5 cm) and clear cell papillary renal cell carcinoma (0.5 cm); patient 3 - papillary renal cell carcinoma (5.0 cm) and eosinophilic variant of chromophobe renal cell carcinoma (1.0 cm); patient 4 - chromophobe renal cell carcinoma (4.0 cm) and clear cell papillary renal cell carcinoma (0.6 cm). Immunohistochemical studies for cytokeratin 7, carbonic anhydrase IX, high molecular weight cytokeratin, CD10, and alpha-methyl acyl-CoA racemase (AMACR) confirmed the separate components in all. Conclusion This series adds to the spectrum of causes that may contribute to discordant results of renal mass biopsy and resection specimens. Secondary smaller tumors appear to be predominantly nonaggressive histologies, enriched for clear cell papillary renal cell carcinoma. Pathologists and urologists should be aware of this occurrence when considering the role of renal mass biopsy and interpreting the results.


2021 ◽  
Vol 8 ◽  
Author(s):  
Feng Yu ◽  
Qian Xu ◽  
Xian-Gen Liu

Objective: To analyze the impact of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) on outcomes of complex clear cell renal cell carcinoma (ccRCC).Methods: A total of 132 high-complex ccRCC patients with a Radius Exophytic Nearness Anterior Location (R.E.N.A.L) score ≥7 enrolled in our hospital between January 2018 and June 2020 were matched and assigned to an LPN group (given LPN treatment) and an OPN group (given OPN treatment), with 66 cases in each group. Two weeks and 3 months after the operation, the renal indexes, inflammatory factors, basic perioperative conditions, and incidence of complications were compared.Results: Two weeks after the operation, the levels of SCr and CysC were elevated, with higher levels observed in the LPN group (all P < 0.05), and the eGFR levels were reduced, with a lower result in the LPN group. Three months after the operation, the two groups observed decreased levels of SCr and CysC, and an increased level of eGFR; moreover, the decreased SCr and CysC levels were still higher, and the increased eGFR was lower than those before the operation (P < 0.05). The levels of CRP and TNF-α in the two groups increased after the operation, with a lower outcome in the LPN group (P < 0.05). Moreover, the LPN group had less intraoperative blood loss and shorter postoperative length of hospital stay but longer blocking time compared to the OPN group (P < 0.05). Patients in the LPN group were recorded with a lower complication incidence compared with the OPN group (3.03 vs. 15.15%, P < 0.05).Conclusion: Both LPN and OPN enjoy significant efficacy in the treatment of complex ccRCC and effectively protect renal function. Moreover, LPN is a more acceptable option for complex ccRCC due to its numerous benefits in postoperative stress response, complications, recovery. which is worthy of promotion with safety and feasibility.


2019 ◽  
Vol 22 ◽  
pp. 19-20
Author(s):  
Florin Ioan Elec ◽  
Andreea Zaharie ◽  
Gheorghiţă Iacob ◽  
Tudor Moisoiu ◽  
Dan Burghelea ◽  
...  

2007 ◽  
Vol 177 (4S) ◽  
pp. 214-214
Author(s):  
Sung Kyu Hong ◽  
Byung Kyu Han ◽  
In Ho Chang ◽  
June Hyun Han ◽  
Ji Hyung Yu ◽  
...  

2019 ◽  
Vol 22 (6) ◽  
pp. 13-22
Author(s):  
E. V. Kryaneva ◽  
N. A. Rubtsova ◽  
A. V. Levshakova ◽  
A. I. Khalimon ◽  
A. V. Leontyev ◽  
...  

This article presents a clinical case demonsratinga high metastatic potential of clear cell renal cell carcinoma combined with atypical metastases to breast and paranasal sinuses. The prevalence of metastatic lesions to the breast and paranasal sinuses in various malignant tumors depending on their morphological forms is analyzed. The authors present an analysis of data published for the last 30 years. The optimal diagnostic algorithms to detect the progression of renal cell carcinoma and to evaluate the effectiveness of the treatment are considered.


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