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PubMed1994

[Circumstances of the detection of kidney cancer. Current part of accidental discoveries].

Kidney cancer accounts for 3% of all cancers, with approximately 85% of tumors arising in the renal parenchyma (renal cell carcinoma). To evaluate the part of the incidental detection of the renal carcinoma, we performed a retrospective review of the 302 patients treated for this reason in our department between April 1981 and October 1992. For the purpose of a historical comparison, 2 periods of 6 years were compared: 1981-1986 and 1987-1992. During 1981 to 1992, 71 patients (25.8%) were totally asymptomatic, with a significant improvement of the incidentally detected tumors from 1981-1986 (15%) to 1987-1992 (33.7%) (p < 0.001). Renal ultrasonography, which is responsible for 97% of the incidental diagnosis, allow for a better detection in the right kidney (60.3% vs. 39.7% in the left kidney) (p < 0.05). Primary tumor size and clinical stage (with Robson or the TNM 1992 classification) were significantly smaller (47.3 +/- 19.9 mm for the asymptomatic group vs. 71.6 +/- 34.1 mm for the symptomatic tumors) and lower respectively, in the asymptomatic group than in the symptomatic group (p < 0.001). The five-year survival rate (actuarial method) of the incidental cases tended to the better for the asymptomatic cases (87.5% vs. 39% for the symptomatic tumors) (p < 0.05). Most of the authors agree that incidental diagnosis has led to lower tumor size and stage and possibly better survival rate compared to cases where the diagnosis was suspected clinically. However, prospective studies on a large scale are needed to evaluate the role of nephron sparing surgery for incidental cancer of the kidney. Nowadays, the treatment remains radical nephectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Kidney cancer in Canada: the rapidly increasing incidence of adenocarcinoma in adults and seniors.

PURPOSE: To examine kidney cancer incidence and mortality patterns since 1969 in Canada. METHOD: Linear regression of the log rates was used to estimate secular trends by age group and sex, and age-period-cohort models were fitted to examine changes in kidney cancer and renal adenocarcinoma incidence rates. RESULTS: A substantial increase in incidence rates was observed among those 35 years and older, with average increases of 2.5% or more annually for both sexes. Age-period-cohort modelling suggested that much of this increase resulted from a period effect. Changes in mortality were much more modest, especially among those aged 0-34, for whom mortality rates actually declined by an average of 4.2% and 5.4% annually for males and females respectively. CONCLUSIONS: Kidney cancer incidence rates have increased significantly, especially renal adenocarcinoma among adults and seniors. Diagnostic improvements and increasing levels of obesity in the Canadian population may have contributed to these trends.

Adenocarcinoma↗

PubMed1993

Review of new evidence regarding the relationship of gasoline exposure to kidney cancer and leukemia.

Four new or updated epidemiologic studies were presented at a meeting on the health effects of gasoline exposure held in Miami, Florida, November 5-8, 1991. A focus of these studies was whether there is a relationship between gasoline exposure and kidney cancer and leukemia. For gasoline distribution workers, who have a relatively high exposure, there was some evidence for a kidney cancer relationship in three studies but none in the fourth. There was evidence for an acute myelocytic leukemia relationship in three studies. The fourth study dealt only with kidney cancer. It is possible that the benzene content of gasoline was responsible for the leukemia findings. It is uncertain whether gasoline exposure is a cause of kidney cancer.

Gasoline↗

PubMed1993

Risk of kidney cancer among patients using analgesics and diuretics: a population-based cohort study.

The aim of this study was to determine the risk of kidney cancer in 2 cohorts defined on the basis of hospital discharge diagnoses associated with analgesic or diuretic use during the period 1965 to 1983. Patients were followed up through 1984 for cancer incidence. After excluding cancers in the first year of observation, 161 kidney cancers were observed vs. 138 expected among 54,662 patients in the analgesics cohort. The relative risk was higher for women than for men. When examined by sub-site within the kidney, risk for cancer of the renal pelvis was similar in magnitude to that for the renal parenchyma. Among 115,616 patients in the diuretics cohort, 278 kidney cancers occurred vs. 209 expected. The risk for women was higher than for men. This elevation in risk was confined to cancer of the renal parenchyma, with no significantly increased risk seen for cancer of the renal pelvis. Although we observed little excess risk among members of the analgesics cohort, the significantly elevated risk among patients using diuretics supports a number of recent studies, but inability to adjust for confounding factors such as obesity preclude drawing any conclusion regarding diuretics. Further research is warranted to assess in detail the relationship between diuretic use and cancer of the renal parenchyma.

Aged↗

PubMedDate not supplied

Neoplastic thrombosis of the inferior vena cava and right atrium due to kidney cancer. Three surgically treated cases.

Extension into vena cava and right atrium of tumor thrombus from a renal cell carcinoma presents a surgical challenge. The use of cardiopulmonary by-pass, hypothermia and cardiac arrest with temporary exsanguination has allowed the successful surgical excision of this tumor. During 1986 and 1987 3 patients with cancer of kidney invading the vena cava were operated on with this surgical technique. No deaths occurred. The possibility of curing this type of cancer with minimal operative risk and good results is discussed.

Aged↗

PubMed1988

Increased levels of fibroblast growth factor-like activity in urine from patients with bladder or kidney cancer.

Growth factor activity was partially purified from human renal tumors and a human bladder cancer cell line by heparin-Sepharose chromatography. This activity stimulated bovine capillary endothelial cell proliferation and DNA synthesis in BALB/c 3T3 cells. Partially purified growth factor preparations from these tumors contained a protein with an approximate molecular weight of 17,000 which was recognized by a polyclonal antiserum raised against a peptide fragment of basic fibroblast growth factor (FGF). This growth factor activity appears to be related to basic fibroblast growth factor. Measurement of FGF-like activity in 50 urine samples from 32 adult males showed that 55% (6 of 11) of the urine samples from patients with bladder cancer and 100% (7 of 7) of the urine samples from patients with kidney cancer contained activity equivalent to more than 20 ng of basic FGF/h of urine production. In contrast, only 6% (2 of 32) of the urine samples from controls, patients with a benign disease, or patients with a history of bladder or kidney cancer contained this level of growth factor activity. These results suggest that patients with bladder or kidney cancer release an FGF-like factor into urine which may be used as a marker for these tumors.

Adenocarcinoma↗

PubMed2001

Local progression after operative treatment of metastatic kidney cancer.

The cases of 78 patients with osseous metastases from kidney cancer were reviewed to determine the rate of local progression after operative resection as compared with more traditional intralesional procedures. Group I consisted of 41 (53%) patients who were treated with intralesional procedures involving internal fixation with or without curettage or polymethylmethacrylate. Of the 41 patients, additional operations were recommended for 17 (41%) of the patients who had local osseous progression. Fourteen additional procedures including nine wide resections with reconstruction, three amputations, and two mass excisions were done. Group II consisted of 37 (47%) patients who were treated with marginal or wide resection with or without reconstruction. In this group, only one patient required additional operative intervention for local osseous progression. Median survival of patients in Group I was 20 months compared with 35 months for patients in Group IL This study shows that despite shorter average survival, patients who undergo intralesional surgery are at high risk of reoperation for local progression. Resectional surgery should be considered in patients with skeletal metastases from kidney cancer to lessen the risk of reoperation for local progression.

Bone Neoplasms↗

PubMed1988

[Early detection of urogenital cancers: kidney, bladder, prostatic and testicular cancers].

Since there is no definition of early cancer for the genitourinary tract yet, so we tried to make a definition of it before main subjects are discussed. States of early cancer are thought to be small, to have neither surrounding invasion nor metastasis and also to have possibility to be found and to be cured. The early cancers of the genitourinary tracts are primary lesion less than 3 cm in diameter of the renal cell carcinoma, prostatic cancer of stage A and B and testicular tumor of pT1N0M0. Definition of bladder cancer is too difficult to be established at the present time.

Biomarkers, Tumor↗

PubMed1996

A nested case-control study of kidney cancer among refinery/petrochemical workers.

A nested case-control study was designed to evaluate whether a nearly twofold excess of kidney cancer among workers at a refinery/petrochemical plant was associated with cumulative exposure to C2-C5 saturated, C2-C5 unsaturated, C6-C10 aliphatic saturated, C6-C10 aliphatic unsaturated, and C6-C10 aromatic process streams. Nonoccupational risk factors were body mass index (BMI), blood pressure (both measured at about age 28), and smoking. There was no significant association with cumulative exposure or tenure as estimated by conditional logistic regression and adjusted for nonoccupational risk factors. Categorical analysis showed increased odds ratios only in the second (low) and fourth (high) quartiles compared to the first quartile reference group of lowest exposed workers, and a three-quarter-fold increased odds ratio for > 32 years' tenure compared to the < 25-year reference group. The number of cases was small with wide confidence intervals around estimate of risk, so the possibility of an exposure-response trend cannot be ruled out. Multivariate analysis identified overweight (high BMI; p < 0.01) as the most important risk factor in this data set, followed by tenure and increased blood pressure. There was a weak association with current smoking, but not with pack-years smoked. The risk of kidney cancer for a nonsmoker with normal blood pressure but 25% overweight was increased about 2.6-fold (95% CI = 1.2-5.4). The risk of kidney cancer for a nonsmoker of normal weight with high blood pressure (e.g., 150/110), was increased about 4.5 (95% CI, 0.8-26).

Adult↗

PubMed2004

Repeated cycles with 72-hour continuous infusion interleukin-2 in kidney cancer and melanoma.

While high-dose bolus inpatient interleukin-2 is generally given on 8-week cycles, continuous infusion interleukin-2 could potentially allow for more rapidly repeated cycles. Fourteen (14) patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1, having either kidney cancer (6) or melanoma (8), have been treated with continuous infusion (CIV) interleukin-2 (IL-2) 18 MIU/m(2)/24 hours for 72 hours. Cycles were repeated every 3 weeks up to 4 cycles, then every 3-4 weeks for 2 cycles, then every 6-8 weeks, until progression or intolerable toxicity. All patients received famotidine 20 mg intravenously (i.v.) twice per day during the 72-hour infusions. Patient characteristics included a median ECOG performance status of 1; median age = 63 (range: 25-79); most common metastatic sites: lung (9), bone (5), lymph nodes (5), and the liver (3). No patients with metastatic kidney cancer underwent a nephrectomy prior to interleukin-2. Median number of cycles received = 5 (1-9). No patients required Intensive Care Unit (ICU) admission. There have been no treatment-related deaths. Most common toxicities have been rigors, fever, nausea/emesis, and the reversible elevation of creatinine. One complete response and three partial responses (67% response rate; 95% confidence interval: 30%-90%) have been seen in kidney cancer, and two partial responses (25% response rate; 95% confidence interval: 7%-60%) have occurred in melanoma. Median survival has not been reached at >9+ months. Responding sites include the liver, bone, lung, lymph node and subcutaneous sites. Inpatient 72-hour continuous infusion interleukin-2 at this dose and schedule is well tolerated by patients with an ECOG performance status of 0 or 1 and has activity in kidney cancer and melanoma.

Adult↗

PubMed2003

The von Hippel-Lindau gene, kidney cancer, and oxygen sensing.

Recent studies of a relatively rare hereditary cancer syndrome, von Hippel-Lindau (VHL) disease, have shed new light on the molecular pathogenesis of kidney cancer and, perhaps more important, on how mammalian cells sense and respond to changes in oxygen availability. This knowledge is already translating into new therapeutic targets for kidney cancer as well as for multiple conditions, such as myocardial infarction and stroke, in which ischemia plays a pathogenic role. This review summarizes the current knowledge of the molecular pathogenesis of von Hippel-Lindau disease and the role of the VHL gene product (pVHL) in kidney cancer and the mammalian oxygen sensing pathway.

Animals↗

PubMed2003

Quality of life aspects in kidney cancer patients: data from a national registry.

GOALS: We investigated quality of life aspects, including health-related quality of life, psychological functioning, relationship issues and sexual functioning in kidney cancer patients. PATIENTS AND METHODS: We conducted an anonymous, cross-sectional survey of a random sample of patients with kidney cancer from a national database. A questionnaire was mailed to 301 members of the Kidney Cancer Association. The questionnaire included demographics, medical history, the Watts Sexual Function Questionnaire (WSFQ), the SF-12 Health Survey, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Revised Dyadic Adjustment Scale (RDAS). RESULTS: Of the 266 eligible participants, 84 (33%) returned the questionnaire. The mean ages of the respondents were 57.5 and 57.9 years for men and women, respectively. Overall, the total WSFQ scores as well as the four domain scores (desire, arousal, orgasm and satisfaction) were similar in men and women, and lower than in female breast cancer and male hypertensive populations reported in the literature, indicating relatively worse sexual function. While subjects reported health-related quality of life and relationship scores similar to the general population, 51% of men and 57% of women reported depressive symptoms (CES-D >/=16). CONCLUSIONS: This is the first study in which sexual function in patients with renal cancer has been addressed. While most patients remain sexually active in non-distressed relationships, many reported depressive symptoms, and sexual functioning may be worse than in comparable chronically ill populations. Quality of life and sexual function issues should be addressed when counseling urological cancer patients.

Adult↗

PubMed1999

Kidney cancer mortality in The Netherlands, 1950-94: prediction of a decreasing trend.

BACKGROUND: Incidence and mortality rates of kidney cancer are known to be increasing world-wide. The reasons for these increases are not clear, but despite this it may still be possible to predict changes in the trend of occurrence. METHODS: Male and female kidney (plus ureter and urethra) cancer mortality per 10(5) person-years, from 1950 to 94, were calculated using national demographic and mortality data. Changes in the age structure of the Dutch population were adjusted using direct standardisation to the European standard population. The effects of age, calendar period and birth cohort on the temporal trend in mortality were evaluated using log-linear modelling. RESULTS: Male mortality from kidney cancer increased from three per 10(5) person-years in the 1950s to eight per 10(5) in the mid 1980s and remained relatively stable thereafter. Female mortality rates showed a comparable trend, from two per 10(5) in the 1950s to four per 10(5) in the 1980s. In addition to the effects of age, the temporal trend in males can be sufficiently explained as a birth cohort effect. Successive birth cohorts appear to have higher risks of dying from kidney cancer until the 1930 cohort. The younger birth cohorts appear to have lower risks. The trend in women is comparable to that in men but is less pronounced and shows only after excluding women under the age of 45. CONCLUSION: The decreasing risk for generations born after 1930 will probably result in a decreasing trend in kidney cancer mortality in the near future. It is suggested that at least part of this changing trend in men (but not in women) is caused by the changing smoking behaviour of the Dutch population.

Adolescent↗

PubMed2004

Molecular cytogenetic characterization shows higher genetic homogeneity in conventional renal cell carcinoma compared to other kidney cancers.

In this study seven primary kidney tumors out of 13 were cytogenetically characterized by comparative genomic hybridization (CGH) on the surgical specimens as well as by spectral karyotyping (SKY) analysis after short-term culturing. In two of the seven cases only a normal karyotype was identified. Non-clonal aberrations were observed in four of the seven cases. Overall numerical alterations were more frequent than structural changes. The two structural alterations identified constituted of a deletion of the short arm of chromosome 3 in a conventional renal cell carcinoma (RCC), and a ring chromosome derived from chromosome 8 in a papillary RCC. By CGH gains of copy number were revealed on chromosomes 3, 5, 7, 8q, and 20, while the losses encompassed 3p and 17p. In the papillary RCCs only gains were found. Comparison between SKY and CGH data suggests that the conventional RCCs are genetically more homogeneous than the other types of kidney cancer. In the two papillary RCCs, trisomies of chromosomes 7 and 17 were typical findings. In the transitional cell carcinoma different findings by CGH and SKY would suggest that these tumors constitute a heterogeneous population of tumor cells which could represent different steps of somatic evolution of tumors.

Adult↗

PubMed2001

Evaluation of organ sparing operation results from planned indications in patients with kidney cancer.

An analysis in 53 patients with kidney cancer has been conducted, a group on which kidney sparing operations have been performed. 25 women and 28 men have been examined at the age of 53.7 in the postoperative period of 7 divided by 130 months. The average observation time without any recurrences or metastases was 48.8 months. 5.7% local and 1.9% remote decease related recurrences have been found. The stage of clinical progression and the degree of histological malignancy are factors determining the five-year survival being 98.0%, while without any recurrences or metastases being 88.4%.

Adult↗

PubMed1993

Risk factors for kidney cancer in New South Wales. IV. Occupation.

In a population based case-control study of kidney cancer in New South Wales, data from structured interviews with 489 cases of renal cell cancer (RCC), 147 cases of renal pelvic cancer (CaRP), and 523 controls from the electoral roles were obtained about employment in certain industries or occupations, and exposure to particular chemicals chosen because of suspected associations with kidney cancer. A low level of education increased the risk for CaRP but not RCC. After adjustment for known risk factors, exposure to asbestos significantly increased the risk for RCC (relative risk (RR) = 1.62; 95% confidence interval (95% CI) 1.04-2.53). Working in the dry cleaning industry had a stronger link with CaRP (RR = 4.68; 95% CI 1.32-16.56) than with RCC (RR = 2.49; 95% CI 0.97-6.35). Working in the iron and steel industry doubled the risk for CaRP (RR = 2.13; 95% CI 1.04-4.39) whereas employment in the petroleum refining industry had a non-significant association with CaRP (RR = 2.60; 95% CI 0.88-7.63) and none with RCC.

Adult↗

PubMed2001

[Role of multiarray scanner in the choice of therapeutic strategy in kidney cancer. Report of a case of kidney tumor with double thrombus in inferior vena cava].

Renal cancer with caval thrombus is a disease which requires precise preoperative assessment, in order to adapt the surgical technique to the stage and extent of the disease. Recent developments in CT imaging, spiral acquisition and, more recently, the multiarray technique, allow a high quality evaluation. In the light of a case of right renal tumour with bifocal caval extension, the authors discuss the valuable contribution of this imaging modality in the staging assessment and evaluation of arterial (single or multiple artery, anatomical situation in relation to the left renal vein, presence of early bifurcations, etc.), and venous structures (renal vein, genital vein, extension of the thrombus, lumbar vein and hepatic vein). Improvements in CT imaging constitute a major progress in the staging of renal cancers with caval thrombus and make a considerable contribution to the choice of treatment strategy.

Aged↗

PubMed1999

[Molecular genetic mechanism of hereditary human kidney cancer development].

Here we reviewed the molecular genetic mechanism in the development of 4 types of human hereditary kidney cancers. These include von Hippel-Lindau (VHL) disease, hereditary papillary renal carcinoma, familial renal cancers with translocation of chromosome 3, and Tuberous sclerosis. Loss of function of the VHL disease gene is responsible for the von Hippel-Lindau disease and major portion of sporadic clear cell renal carcinoma. Activated c-Met oncogene is responsible for the development in some cases of hereditary papillary renal cell carcinomas and sporadic papillary renal carcinomas. There are several cases of familial renal carcinoma in that translocations of chromosome 3 p are demonstrated. The molecular genetic mechanism of this disease is not known. Several reports show the development of renal cell carcinoma in Tuberous sclerosis patients. TSC 1 or TSC 2 gene may be responsible for these tumors. The detail in this disease not well known. Molecular genetic analyses for hereditary renal cancer identified several oncogenes and tumor suppressor genes in hereditary as well as sporadic renal carcinomas. Future studies may reveal new category of oncogenes or tumor suppressor genes that are involved in the human kidney cancer development.

Amino Acid Sequence↗