Renal cell carcinoma for the nephrologist
Renal cell carcinoma (RCC), a malignancy whose incidence is increasing, is frequently encountered in general nephrology practice when acute and chronic kidney disease occurs in the course of disease. Importantly, when kidney disease develops in the setting of RCC, mortality is significantly increased with patients often dying of a non-cancer-related complication of kidney disease. As such, practicing nephrologists need to have a working knowledge of this cancer ’s biology, treatment, and complications.
Partial nephrectomy (PN) for clinically localized renal cell carcinoma (CLRCC) allows for comparable oncologic benefit to radical nephrectomy with improved preservation of renal function in pT1-T2 masses. The decreased impact on GFR in patients within normal or near normal renal function is less important than the change observed in those patients with chronic kidney disease (CKD). We aimed to investigate the rates and risk factors for CKD upstaging after PN in patients with normal and at-risk kidneys, and to understand how surgically modifiable factors influence that relationship.
Though radical cytoreductive nephrectomy has been shown to improve overall survival in patients with metastatic renal cell carcinoma, the impact this treatment has on renal function has not been adequately assessed. Radical nephrectomy in patients with localized cancer has been associated with risk of chronic kidney disease development. Using patients enrolled in ADAPT trial that received cytoreductive nephrectomy in the metastatic setting, we intend to study the effect of this procedure on overall renal function in patients without kidney disease.
In this study, we examined the associations of RN versus PN with oncologic and non-oncologic outcomes using a large institutional cohort.
Conclusion: Our hypothesis that a chronic uranium exposure is associated with an increased risk of cancer mortality or of kidney failure is refuted by clinical data. The decreased risk may result from better medical surveillance of uranium workers.Nephron Extra 2016;6:1-11
ConclusionsWithin an equal access healthcare system, Hispanics seem to be diagnosed at younger ages, to have greater comorbidities and to present more frequently with clear cell renal cell carcinoma compared with non‐Hispanic white patients. Despite lower stage and greater receipt of surgery, Hispanic ethnicity seems to be an independent predictor of mortality. Further work is necessary to confirm these findings.
lli A Abstract INTRODUCTION: There is a lack of validated quality metrics to evaluate the care of patients receiving surgery for renal cell carcinoma (RCC). To address this, the Kidney Cancer Research Network of Canada defined a list of quality indicators (QI) to assess hospital-level performance. We have case-mix adjusted these QIs to benchmark RCC surgical care at Canadian academic centres. METHODS: The Canadian Kidney Cancer information system (CKCis) was used to measure six QIs: laparoscopic approach proportion (LA), partial nephrectomy proportion (PN), partial nephrectomy in patients with chronic kidney ...
This study is aimed to explore the influence of human renal cell cancer cells (786-0) and human renal tubular epithelial cells (HK-2) on RECK expression, proliferation and angiogenesis of adjacent microvascular endothelial cells (HMEC-1) under chemical hypoxia. Cobalt chloride (CoCl2 ) treatment was used to simulate the hypoxia environment in RCC and CKD. Co-culture, cell proliferation assay and tube formation assay were used to evaluate the influence of 786-0 or HK-2 cells on proliferation and angiogenesis of adjacent HMEC-1 cells. Effects of different environments on RECK expressions in 786-0, HK2 or HMEC-1 cells were de...
In conclusion, image-guided percutaneous ablation should be considered a viable, curative option for stage IA renal cell carcinoma.
In conclusion, image-guided percutaneous ablation should be considered a viable, curative option for stage IA renal cell carcinoma. PMID: 27870681 [PubMed - in process]
Conclusions: Whenever feasible, PN should be considered for renal masses ≥4 cm, as this technique shows better long-term results regarding disease-specific survival and renal function preservation in our study group.Urol Int