REVIEW ARTICLE Edwin M. Posadas, Robert A. Figlin;ONCOLOGY Vol. 26 No. 3 This article will review the recent advances that form the current framework of therapy for RCC, as well as summarize key areas of progress and innovation in the evolving treatment paradigms for this disease.
SECOND OPINION Elaine T. Lam et al;ONCOLOGY Vol. 25 No. 9 The patient is a 43-year-old man who was initially evaluated at an outside institution for unexplained anemia and who was found to have a large right kidney mass. He underwent a radical nephrectomy for a 19-cm large-cell, poorly differentiated neoplasm.
TEST YOUR IMAGE IQ Patient's review of systems is negative with the exception of complaints about mild right-sided postero-lateral flank pain. What should be done first:
A. Tell the patient this is a benign cherry angioma and offer electrodesiccation. B. Test for HIV because this lesion could represent bacillary angiomatosis. C. Order a PET scan. D. Perform a urinalysis.
A study found that robotic partial nephrectomy to remove kidney cancer tumors resulted in better outcomes, but also had significantly higher hospital charges. The data were presented at the annual meeting of the American... More »
Acetaminophen and nonaspirin nonsteroidal anti-inflammatory drugs were associated with a 28% increased risk of developing kidney cancer, according to the results of a recently published meta-analysis. More »
A phase I study of the use of stereotactic radiosurgery as a therapeutic option for patients with localized, inoperable primary renal cancer showed that the treatment modality effectively stabilized or decreased disease in a... More »
In the current critical review we discuss these emerging trends in localized and systemic treatment as well as possible interesting combinations of the two modalities. Finally, we discuss the role of the new systemic agents... More »
ImmunoSPECT imaging shows that the effectiveness of a newly developed radioimmunotherapy for treating a resistant form of kidney cancer could be diminished when used after another anti-cancer therapy. More »
CancerNetwork speaks with Dr. Michael Atkins, who has extensive clinical experience in kidney cancer and development of various new treatments and is presenting this weekend during the renal cancer translational science... More »
The US Food and Drug Administration (FDA) has approved the angiogenesis blocker axitinib (Inlyta), a twice daily oral drug, as a second-line treatment for patients with advanced renal cell carcinoma. More »
Study Type--Cohort study Level of Evidence 2b. What's known on the subject? and What does the study add? Laparoscopic radical nephrectomy for renal cancer provides equivalent long-term cancer control with shorter hospital stays, less postoperative pain, and faster resumption of normal activities, but it has diffused slowly into clinical practice, perhaps as a result of perceptions about safety. Patient safety outcomes for laparoscopic and open radical nephrectomy using validated measures remain incompletely characterized. This is the first study to investigate peri-operative outcomes of radical nephrectomy using validated patient safety measures. We found a 32% decreased probability of adverse patient safety events occurring in laparoscopic compared with open radical nephrectomy. The safety benefits of laparoscopy were attained only after 10% of cases were completed laparoscopically--a proportion some have proposed as the 'tipping point' for the adoption of surgical innovations. This
Accompanying the increased use of biologic and non-biologic antirheumatic agents, patients with RA have been exposed to an increased risk of Pneumocystis jirovecii infection, which causes acute fulminant P. jirovecii pneumonia (PCP). Mortality in this population is higher than in HIV-infected individuals. Several guidelines and recommendations for HIV-infected individuals are available; however, such guidelines for RA patients remain less clear. Between 2006 and 2008 we encountered a clustering event of P. jirovecii infection among RA outpatients. Through our experience with this outbreak and a review of the recent medical literature regarding asymptomatic colonization and its clinical significance, transmission modes of infection and prophylaxis of PCP, we have learned the following lessons: PCP outbreaks among RA patients can occur through person-to-person transmission in outpatient facilities; asymptomatic carriers serve as reservoirs and sources of infection; and short-term
UDP-glucuronosyltransferase (UGT) 2A1 is a respiratory and aerodigestive tract-expressing phase II detoxifying enzyme that metabolizes various xenobiotics including polycyclic aromatic hydrocarbons (PAHs). In the present study, a novel exon 3 deletion splice variant was identified for UGT2A1 (UGT2A1exon3). As determined by reverse transcription-polymerase chain reaction (PCR), UGT2A1exon3 was shown to be expressed in various tissues including lung, trachea, larynx, tonsil, and colon. The ratio of UGT2A1exon3/wild-type UGT2A1 expression was highest in colon (0.79 0.08) and lung (0.42 0.12) as determined by real-time PCR; an antibody specific to UGT2A1 showed splice variant protein (UGT2A1_i2) to wild-type protein (UGT2A1_i1) ratios in the range of 0.5 to 0.9 in these tissues. Using ultra-pressure liquid chromatography, we found that homogenates prepared from UGT2A1_i2-overexpressing human embryonic kidney 293 cells exhibited no glucuronidation activity against PAHs,
The benefits of biocompatible peritoneal dialysis (PD) fluids, particularly for residual renal function (RRF), are controversial. Moreover, the clinical effects of a PD regimen consisting of different biocompatible PD fluids have not been fully established.|Prospective, randomized, controlled, open-label study.|Patients with end-stage kidney disease newly started on continuous ambulatory PD therapy (N = 150).|A 12-month intervention with 3 biocompatible PD fluids (a neutral-pH, low glucose degradation product, 1.5% glucose solution; a solution with 1.1% amino acid; and a fluid with 7.5% icodextrin) or conventional PD fluid.|The primary outcome was change in RRF and daily urine volume. Secondary outcomes were peritoneal transport and inflammation markers.|RRF, daily urine volume, serum and dialysate cytokine levels.|RRF(3.24 1.98 vs 2.88 2.43 mL/min/1.73 m(2); P = 0.9) and rate of decline in RRF (-0.76 1.77 vs -0.91 1.92 mL/min/1.73 m(2) per year; P = 0.6) did not differ
To define the safely tolerated doses to organs at risk (OARs) adjacent to the target volume (TV) of spine radiosurgery (SRS) with 18-Gy in a single fraction.|A total of 124 patient cases with 165 spine metastases were reviewed. An 18-Gy single-fraction regimen was prescribed to the 90% isodose line encompassing the TV. A constraint of 10 Gy to 10% of the spinal cord outlined 6 mm above and below the TV was used. Dosimetric data to OARs were analyzed.|A total of 124 patients (100%) were followed-up, and median follow-up time was 7 months (1-50 months). Symptoms and local control were achieved in 114 patients (92%). Acute Radiation Therapy Oncology Group (RTOG) grade 1 oral mucositis occurred in 11 of 11 (100%) patients at risk for oropharyngeal toxicity after cervical spine treatment. There were no RTOG grade 2-4 acute or late complications. Median TV was 43.2 cc (5.3-175.4 cc) and 90% of the TV received median dose of 19 Gy (17-19.8 Gy). Median (range) of spinal cord maximum dose (Dmax
A 48-year-old woman presents with history of hematuria and abdominal pain spanning several days. The patient does not have any previous tumor history. Radiological evaluation revealed the presence of a large mass in the upper pole of the right kidney. Right nephrectomy was performed.
CancerNetwork speaks with Dr. Michael Atkins, who has extensive clinical experience in kidney cancer and development of various new treatments, and is presenting this weekend during the renal cancer translational science session at the American Society of Clinical Oncology 2012 Genitourinary Cancers Symposium.
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.