Background: Primary renal leiomyosarcoma (LMS) is an exceedingly rare entity with a poor prognosis. We summarized the clinicopathological characteristics, treatment choice, and survival outcomes of LMS from the Surveillance, Epidemiology, and End Results (SEER) database.Methods: Renal LMS and kidney renal clear cell carcinoma (KIRC) data from 1998 to 2016 were collected from the SEER database. The continuous variables were analyzed using t-tests, while the categorical variables were analyzed using Pearson's chi-squared or Fisher's exact tests. Propensity score matching (PSM) was also performed. The cancer-specific survival (CSS) and overall survival (OS) curves were estimated using Kaplan-Meier analyses and compared by log-rank tests. The risk factors for CSS and OS were estimated using univariable and multivariable Cox proportional hazard regression models.Results: A total of 140 patients with renal LMS and 75,401 patients with KIRC were enrolled. These groups differed significantly in sex, race, tumor size, grade, SEER stage, surgery, radiation, and chemotherapy. Renal LMS exhibited poorer CSS and OS compared with KIRC before and after PSM. For renal LMS, the univariate Cox proportional hazard regression model indicated that larger tumor size, higher tumor grade, higher SEER stage, and chemotherapy were risk factors for CSS and OS, while surgery appeared to be a protective factor. However, only tumor grade, SEER stage, and receiving surgery remained independent prognostic factors in the multivariable Cox proportional hazard regression model. In addition, subgroup analyses indicated that surgery remained a protective factor for advanced renal LMS. However, there was no survival benefit for patients receiving chemotherapy.Conclusions: Primary renal LMS is an exceedingly rare entity with distinct clinicopathological features and a poor prognosis. A higher tumor grade and late stage may indicate a poor prognosis. Complete tumor resection remains to be the first treatment choice, while chemotherapy may be a palliative treatment for patients with advanced disease.
Background The purpose of this article is to discuss the statistical methods for agreement analysis used in Richelle’s article (BMC Med Educ 22:335, 2022). The authors investigated the attitudes of final-year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes. Methods We found that Cohen’s kappa value for measuring the agreement between these medical students’ attitudes towards drugs/alcohol use during pregnancy was questionable. In addition, we recommend using weighted kappa instead of Cohen’s kappa for agreement analysis at the presence of three categories. Results The agreement improved from “good” (Cohen’s kappa) to “very good” (weighted kappa) for medical students’ attitudes towards drugs/alcohol use during pregnancy. Conclusion To conclude, we recognize that this does not significantly alter the conclusions of the Richelle et al. paper, but it is necessary to ensure that the appropriate statistical tools are used.
Background: Hypoxia up-regulated 1 (HYOU1) was identified as a proto-oncogene and involved in tumorigenesis and progression in several cancer. Nonetheness, the biological function and mechanism of HYOU1 in bladder cancer (BCa) remian unclear.Methods: The HYOU1 level in BCa tissues and cells was examined using RT-qPCR and western blot method. The biological role of HYOU1 on BCa cell proliferation, apoptosis, migration and invasion were analyzed via CCK-8, flow cytometry, wound healing and Transwell assays, respectively. The association between HYOU1 and the PI3K/AKT/FOXO1 signalling was assessed via western blot assay, meanwhile the the association of FOXO1 with HYOU1 was also investigated.Results: HYOU1 was up-regulated in BCa tissues and cell lines. The increased expression level of HYOU1 was indicated the poor prognosis. HYOU1 depletion impeded cell proliferation, migration and invasion, and induced cell apoptosis, while HYOU1 overexpression promoted cell proliferation, migration and invasion. Mechanically, our results showed that HYOU1 knockdown repressed PI3K/AKT/FOXO1 pathway and HYOU1 was negative regulated by FOXO1 in BCa. Significantly, we confirmed that the HYOU1/PI3K-AKT/FOXO1 negative feedback loop was involved in BCa cell proliferation, migration and invasion. Conclusions: These findings revealed that HYOU1 acted as a pro-oncogene on BCa developent and progression, and it will be a possible target for BCa treatment.
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