Comparision of histologic distribution of RCC in young and older patients: Results from the SEER database.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 419-419 ◽  
Author(s):  
Michael R. Daugherty ◽  
Stephen Blakely ◽  
Oleg Shapiro ◽  
Gennady Bratslavsky
Keyword(s):  
Renal Cell ◽  
Clear Cell ◽  
Collecting Duct ◽  
Cell Cancer ◽  
Age Groups ◽  
Genetic Mutations ◽  
Chi Square ◽  
Younger Patients ◽  
The Difference ◽  
Chi Square Analysis

419 Background: Renal cell cancer (RCC) incidence is relatively low in younger patients, encompassing 3-5% of all RCC tumors. These tumors tend to be due to hereditary syndromes and genetic mutations that predispose to cancer development. Patients with hereditary renal cancer (HRC) are at a higher risk of multiple tumors and bilateral disease. We hypothesize that there is a difference in histologic distribution in the younger patients and that the younger distribution contains more aggressive histologic subtypes. Methods: SEER 18-registries database was queried for all patients ≥20 years old that were surgically treated for renal cell carcinoma between the years 2001 and 2008. Patients with unknown race, grade, stage, or histology were excluded from the study. Histologies selected were clear cell, papillary, chromophobe, sarcomatoid, and collecting duct. Three cohorts were created with the ages 20-44, 45-64, and ≥65 year olds that contained 3,926, 19,661, and 16,323 patients respectively. Chi-square analysis was used to compare the histologic distributions between the cohorts. Results: There was no difference in the incidence of clear cell RCC between the three cohorts (p = 0.63). The histology distribution was not different in the 45-64 year olds compared to those ≥65 (p = 0.47). The non-clear cell histologies were different between the 3 age groups (p < 0.001). There were a larger percentage of patients in the younger patients that had chromophobe tumors compared to all non-clear cell histologies (p< 0.001). Conclusions: The difference in the non-clear cell histologic distribution between the groups is most likely due to genetic mutations predisposing these patients to chromophobe RCC. There has been limited data on HRCs, due in large part to its low incidence. Although the HRCs are known to have a most common histology, it is likely that this information is incomplete, as younger patients have undiagnosed genetic mutations that led to development of chromophobe tumors. [Table: see text]

A novel preoperative inflammatory marker prognostic score in patients with clear cell and non-clear cell renal cell carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 530-530
Author(s):  
Rishi Robert Sekar ◽  
Dattatraya Patil ◽  
Jeff Pearl ◽  
Yoram Baum ◽  
Omer Kucuk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Medical Decision ◽  
Chi Square ◽  
Cell Renal Cell Carcinoma ◽  
Clear Cell Rcc ◽  
Chi Square Analysis

530 Background: Several inflammatory markers have been studied as potential biomarkers in clear cell renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies. We hypothesize that a combination of preoperative C-Reactive Protein (CRP), albumin, Erythrocyte Sedimentation Rate (ESR), corrected calcium, and AST/ALT ratio into a RCC Inflammatory Score (RISC) could serve as a rigorous prognostic indicator in patients with clear cell and non-clear cell RCC. Methods: Patients that underwent nephrectomy for localized RCC were queried from our nephrectomy database. The optimal threshold for individual biomarkers was determined using grid search methodology, receiver operating characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. The final score, RISC, was the sum of points accrued from each biomarker (Table). ROC and chi-square analysis was performed to compare the prognostic ability of RISC to SSIGN and UISS. Impact on overall survival was analyzed with multivariate logistic regression analysis. Results: 391 patients were included in the study. Area under the curve (AUC) for RISC, SSIGN, and UISS was 0.78, 0.78, and 0.81, respectively. Chi-square analysis of AUCs revealed no statistically significant difference between RISC, SSIGN, and UISS (p= 0.820, and p =0.317, respectively). On multivariate analysis, after adjusting for confounding variables, each unit increase in RISC was associated with a 32% increase in mortality (HR=1.32, 95%CI 1.17-1.49, p<0.001). Conclusions: RISC is an independent and significant predictor of overall survival in clear cell and non-clear cell RCC with accuracy at least as good as other established prognostic tools. Notably, RISC is composed of standardized preoperative laboratory markers, allowing crucial prognostic information to be integrated into medical decision making prior to surgery. [Table: see text]

scholarly journals Studies on Plasmodium falciparum Infection Rates among Patients Attending General Hospitals in Benue State, Nigeria

2020 ◽  
pp. 1-8
Author(s):  
O. A. Adulugba ◽  
O. Amali ◽  
F. T. Ikpa ◽  
M. M. Manyi ◽  
V. U. Obisike
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Infection ◽  
Informal Education ◽  
Age Groups ◽  
Chi Square ◽  
General Hospitals ◽  
Significant Difference ◽  
The Difference ◽  
Chi Square Analysis ◽  
Preventive Methods

Plasmodium falciparum is the most virulent and prevalent malaria parasite in Nigeria .This study aimed to determine the prevalence of malaria infection among patients at General Hospitals in Benue State. A total of 1200 patients were examined in this study.  Blood samples were collected by finger prick onto clean slides and into the round sample well of PfRDTs. Thick and thin blood films were prepared for microscopic examination. The overall prevalence of malaria infection was 34.8%. A questionnaire was used to determine some demographic factors. Prevalence of malaria in relation to residence, rural area recorded higher prevalence of 42.2% than urban area with prevalence of 23.8%. Chi square analysis showed a significant difference (p < 0.05) in prevalence in relation to residence. The Prevalence of malaria in relation to age groups, age between 6-10 and 7-15 recorded higher infection rate of 54.5% and 51.5% respectively. While, age group >46 recorded  17.5%. The female patients 36.2% were more infected than the males 33.1%.Patients that had informal education recorded higher prevalence rate of 89.2% and those that are farmers had 57.9%. Chi square analysis however showed that the difference was significant (p < 0.05). A significant difference  (P<0.05) was observed between patients that  used insecticide spray alone as malaria preventive methods (70.1%) compared to patients that used combined methods of prevention (17.2%). Malaria still remains prevalent among patients in Benue State, Nigeria.

A novel preoperative inflammatory marker prognostic score in patients with clear cell renal cell carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 566-566
Author(s):  
Rishi Robert Sekar ◽  
Dattatraya Patil ◽  
Jeff Pearl ◽  
Yoram Baum ◽  
Omer Kucuk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Medical Decision ◽  
Chi Square ◽  
Cell Renal Cell Carcinoma ◽  
Clear Cell Rcc ◽  
Chi Square Analysis

566 Background: Several inflammatory markers have been singularly studied as potential biomarkers in clear cell renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate. We hypothesize that a combination of preoperative C-Reactive Protein (CRP), albumin, Erythrocyte Sedimentation Rate (ESR), corrected calcium, and AST/ALT ratio into a RCC Inflammatory Score (RISC) could serve as a rigorous prognostic indicator in patients with clear cell RCC. Methods: Patients that underwent nephrectomy for localized clear cell RCC were queried from our nephrectomy database. The optimal threshold for individual biomarkers was determined using grid search methodology, receiver operating characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. The final score, RISC, was the sum of all points accrued from each biomarker (Table). ROC and chi-square analysis was performed to compare the prognostic ability of RISC to SSIGN and UISS. Impact on overall survival was analyzed with multivariate logistic regression analysis. Results: 280 patients were included in the study. Area under the curve (AUC) for RISC, SSIGN and UISS was 0.77, 0.78, and 0.81, respectively. Chi-square analysis of AUCs revealed no statistically significant difference between RISC, SSIGN, and UISS (p= 0.975 and p =0.299, respectively). On multivariate analysis, after adjusting for confounding variables, each unit increase in RISC was associated with a 31% increase in mortality (HR=1.31, 95%CI 1.13-1.50, p<0.001). Conclusions: RISC is an independent and significant predictor of overall survival in clear cell RCC with accuracy at least as good as other established prognostic tools. Notably, RISC is composed of standardized laboratory markers easily and cost-effectively obtained preoperatively, allowing crucial prognostic information to be integrated into medical decision making prior to surgery. [Table: see text]

scholarly journals Age is a powerful predictor of survival in pT2N0M0 clear cell renal cell cancer patients: A SEER-based study

2019 ◽  
Author(s):  
Lanting Huang ◽  
Wenfang Cheng ◽  
Juhui Chen ◽  
Kaiyuan Teng
Keyword(s):  
Overall Survival ◽  
Old Age ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Age Groups ◽  
Age At Diagnosis ◽  
Powerful Predictor ◽  
Cancer Specific Survival

Abstract Background: To elucidate whether age is a prognostic factor in clear cell renal cell cancer (ccRCC) with stage II (pT2N0M0,the American Joint Committee on Cancer 6 th or 7 th staging system) , we analyzed data from the SEER (Surveillance, Epidemiology and End Results) database to evaluate the impact of age on clinicopathological features and survival in pT2N0M0 ccRCC patients. Methods: A total of 2806 patients with stage II (pT2N0M0) were collected. Patients were categorized into three groups according to age at diagnosis as follows: young age (< 40 years, n = 129), middle-age (40-69 years, n = 2,075), and old age (≥ 70 years, n = 602) groups. Clinicopathological variables and survival rates were compared between the three groups. Results: 5-year overall survival (OS) rates were 93.0%, 83.9%, 69.3% respectively and 10-year OS rates were 87.6%, 74.5%, 47.0% respectively in the young, middle, and old age groups (P<0.001). 5-year cancer-specific survival (CSS) rates were 94.6%, 88.4%, 84.4% respectively and 10-year CSS rates were 90.7%, 82.1%, 74.6% respectively in the young, middle, and old age groups (P<0.001). Age at diagnosis was the only predictor for both overall survival and cancer-specific survival in multivariate analysis (each P<0.001). Age together with marital status, tumor size and grade were independent prognostic factors for CSS in multivariate analysis (P<0.001,P=0.017, P=0.001, P=0.02 respectively). Conclusions: Age at diagnosis is a powerful predictor for survival in pT2N0M0 clear cell renal cell cancer patients. Compared to their young counterparts, elder patients have a significantly worse outcome with regard to overall survival and cancer-specific survival.

scholarly journals Identification of DNA methylation signatures associated with poor outcome in lower-risk Stage, Size, Grade and Necrosis (SSIGN) score clear cell renal cell cancer

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Louis Y. El Khoury ◽  
Shuang Fu ◽  
Ryan A. Hlady ◽  
Ryan T. Wagner ◽  
Liguo Wang ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Renal Cell ◽  
Lower Risk ◽  
Clear Cell ◽  
Cell Cancer ◽  
Low Risk ◽  
Cell Renal Cell Carcinoma ◽  
A Genome ◽  
Size Grade ◽  
Prognostic Power

Abstract Background Despite using prognostic algorithms and standard surveillance guidelines, 17% of patients initially diagnosed with low risk clear cell renal cell carcinoma (ccRCC) ultimately relapse and die of recurrent disease, indicating additional molecular parameters are needed for improved prognosis. Results To address the gap in ccRCC prognostication in the lower risk population, we performed a genome-wide analysis for methylation signatures capable of distinguishing recurrent and non-recurrent ccRCCs within the subgroup classified as ‘low risk’ by the Mayo Clinic Stage, Size, Grade, and Necrosis score (SSIGN 0–3). This approach revealed that recurrent patients have globally hypermethylated tumors and differ in methylation significantly at 5929 CpGs. Differentially methylated CpGs (DMCpGs) were enriched in regulatory regions and genes modulating cell growth and invasion. A subset of DMCpGs stratified low SSIGN groups into high and low risk of recurrence in independent data sets, indicating that DNA methylation enhances the prognostic power of the SSIGN score. Conclusions This study reports a global DNA hypermethylation in tumors of recurrent ccRCC patients. Furthermore, DMCpGs were capable of discriminating between aggressive and less aggressive tumors, in addition to SSIGN score. Therefore, DNA methylation presents itself as a potentially strong biomarker to further improve prognostic power in patients with low risk SSIGN score (0–3).

C07 Polymorphisms of RAGE and glyoxalase I genes in patients with clear cell renal cell cancer

2013 ◽  
Vol 12 (4) ◽  
pp. e1115, C07
Author(s):  
M. Chocholatý ◽  
K. Havlová ◽  
M. Schmidt ◽  
M. Kalousová ◽  
M. Jáchymová ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Glyoxalase I

NAXIVA: A phase II neoadjuvant study of axitinib for reducing extent of venous tumor thrombus in clear cell renal cell cancer (RCC) with venous invasion.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 275-275
Author(s):  
Grant D. Stewart ◽  
Sarah J. Welsh ◽  
Stephan Ursprung ◽  
Ferdia Gallagher ◽  
Iosif Mendichovszky ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Surgical Approach ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Response Rate ◽  
Clear Cell ◽  
Cell Cancer ◽  
Surgical Morbidity ◽  
Venous Tumor Thrombus ◽  
Extent Of Surgery

275 Background: Venous tumor thrombus (VTT) extension occurs in 4-15% cases of renal cell cancer (RCC). The Mayo classification distinguishes 4 levels of VTT extension between the renal vein and supradiaphragmatic inferior vena cava (IVC). Although surgery is performed with curative intent, mortality is high (5-15%) with complications increasing with the level of the VTT. 5-year survival rates are poor; ~40-65% in non-metastatic RCC. It is hypothesised that neoadjuvant targeted therapy could downstage the VTT reducing the extent of surgery, leading to reduced surgical morbidity and mortality, and increased survival. However, level I or II evidence is lacking. NAXIVA provides the first level II evidence in this patient group, assessing the response of VTT to axitinib. Extensive translational sampling will provide in depth interrogation of VTT (using genomics, proteomics, immunophenotyping and metabolomics) to examine the role of the tumor microenvironment of VTT and response to axitinib. Methods: NAXIVA was a single arm, single agent, multi-center phase 2 feasibility study of axitinib in patients with both metastatic and non-metastatic clear cell RCC prior to nephrectomy and thrombectomy. A Simon two stage minimax design was adopted and the trial designed for adequate power to distinguish a <5% from a >25% improvement in the Mayo VTT level. 21 patients were recruited over a 24 month period between 15/Dec/2017 and 06/Jan/2020 at 5 sites across the UK. Patients were treated with 8 weeks of axitinib (starting dose 5mg bd, increasing to 10mg bd as tolerated) prior to planned surgery. The primary endpoint was the percentage of evaluable patients with an improvement in VTT according to the Mayo classification (assessed using MRI abdomen scans at screening and week 9, prior to surgery. Secondary endpoints were percentage change in surgical approach, percentage change in VTT height, response rate (by RECIST) and evaluation of surgical morbidity assessed by Clavien-Dindo classification. Results: The percentage of evaluable patients with an improvement in VTT according to the Mayo classification was 26.58% [80% CI: 15.76%, 39.74%] (6 of 21 evaluable patients). 35.29% (6 of 17 patients who progressed to surgery) had a change in surgical approach to a less invasive option. There was a median percentage reduction in VTT height of 21.49% (SD=27.60%). The response rate (by RECIST) in the evaluable population was 61.90% SD, 14.29% PR, 9.52% PD. In terms of surgical morbidity 11.76% (2 of 17 patients who progressed to surgery) experienced a Clavien-Dindo 3 or greater complication (0 CD3, 1 CD4, 1 CD5). Conclusions: NAXIVA provides unique prospective data on the feasibility of neoadjuvant axitinib administration to down stage IVC VTT and reduce the extent of surgery. Work is ongoing to establish predictors of response. Clinical trial information: NCT03494816 .

Sex-Role Stereotyping for Selected Sport and Physical Activities across Age Groups

2002 ◽  
Vol 94 (3) ◽  
pp. 743-749 ◽  
Author(s):  
Karen S. Meaney ◽  
Lanie A. Dornier ◽  
Mary S. Owens
Keyword(s):  
Public Schools ◽  
Sex Role ◽  
Age Groups ◽  
Physical Activities ◽  
Chi Square ◽  
Sex Role Stereotyping ◽  
Age Related ◽  
Chi Square Analysis

This investigation was designed to assess sex-role stereotyping across age groups. Participants ( N = 668) were girls and boys, students from Grades 3, 5, 8, and 10 at local public schools. All participants completed the Sport and Physical Activities Questionnaire on which were displayed pictures of 31 sport and physical activities. Participants were instructed to designate each activity as a boys' activity, a girls' activity, or a boys' and girls' activity. Chi-square analysis showed age-related differences in distribution of stereotyping of the activities. Over age groups there were more discrepancies between boys' and girls' ratings of activities as sex-specific. These findings suggest that sex-role stereotyping of sports and physical activities becomes more predominant across age groups.

scholarly journals Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up

2020 ◽  
Vol 22 (3) ◽  
pp. 149-153
Author(s):  
N. A. Ognerubov ◽  
T. S. Antipova ◽  
G. E. Gumareva
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Adrenal Gland ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Primary Site ◽  
The Right

Renal cell cancer metastases without evidence of a primary tumor are extremely rare. These variants are usually showed as a spontaneous description of single clinical cases. Aim.This contribution is a clinical follow-up of synchronous renal cell cancer metastases of unknown primary site. Results.A 52-year-old patient U. with a history of increased blood pressure, up to 170/100 mmHg for the last 5 years, who had undergone many instrumental examinations, including ultrasound examination, because of this disease. The computed tomography of the abdomen showed a 4975 mm heterogeneous tumor in the right adrenal gland in October 2017. The combined positron emission and X-ray computed tomography showed a 795441 mm mass in the right adrenal gland, associated with elevated fluorodeoxyglucose metabolic activity SUVmax 7.25. Focal accumulation of the radiopharmaceutical SUVmax 4.31 in a 171124 mm mass was detected in the space of bifurcation in the mediastinum. The lytic lesion (1015 mm) was found in right superior L3 articular process. The patient underwent retroperitoneoscopic adrenalectomy and thoracoscopic removal of mediastinal tumor in November 2017 because of the oligometastatic nature of the process. The histological study identified clear-cell carcinoma with areas of papillary structure in the right adrenal gland. The immunohistochemical study showed carcinoma cells intensively expressing CD10, and some other cells RCC. The immune phenotype of the tumor was identified as clear-cell renal cell carcinoma. The immunohistological and immunohistochemical analysis reviled the metastases of the same variant of renal cell carcinoma in one of 9 lymph nodes. The patient was treated with pazopanib. The primary renal tumor was not detected during the dynamic observation, including the application of annual combined positron emission and X-ray computed tomography. The patient is alive without disease progression with a follow-up of 32 months. Conclusion.Metastases of clear-cell renal cell carcinoma, including adrenal gland, without evidence of a primary site are extremely rare. The main method of treatment is a combination of surgery and targeted therapy, providing long-term local control of the course of the disease.

scholarly journals Integrated bioinformatics analysis of the NEDD4 family reveals a prognostic value of NEDD4L in clear-cell renal cell cancer

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11880
Author(s):  
Hui Zhao ◽  
Junjun Zhang ◽  
Xiaoliang Fu ◽  
Dongdong Mao ◽  
Xuesen Qi ◽  
...  
Keyword(s):  
Renal Cell ◽  
Prognostic Model ◽  
Cox Regression ◽  
Clear Cell ◽  
Cell Cancer ◽  
Data Sets ◽  
Potential Therapeutic Target ◽  
Cell Renal Cell Carcinoma ◽  
Cellular Energy ◽  
Testing Data

The members of the Nedd4-like E3 family participate in various biological processes. However, their role in clear cell renal cell carcinoma (ccRCC) is not clear. This study systematically analyzed the Nedd4-like E3 family members in ccRCC data sets from multiple publicly available databases. NEDD4L was identified as the only NEDD4 family member differentially expressed in ccRCC compared with normal samples. Bioinformatics tools were used to characterize the function of NEDD4L in ccRCC. It indicated that NEDD4L might regulate cellular energy metabolism by co-expression analysis, and subsequent gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. A prognostic model developed by the LASSO Cox regression method showed a relatively good predictive value in training and testing data sets. The result revealed that NEDD4L was associated with biosynthesis and metabolism of ccRCC. Since NEDD4L is downregulated and dysregulation of metabolism is involved in tumor progression, NEDD4L might be a potential therapeutic target in ccRCC.

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