Influence of vascular endothelial growth factor inhibition on simple renal cysts in patients receiving bevacizumab-based chemotherapy

Abstract

PurposeAlthough angiogenesis has been implicated in the promotion of renal cyst growth in autosomal dominant polycystic kidney disease, no studies have investigated the role of angiogenesis in the growth of simple renal cysts. The aim of current study was to investigate the effect of chemotherapy with the antivascular endothelial growth factor antibody bevacizumab on renal cyst development and growth in cancer patients.Materials and MethodsWe retrospectively reviewed the medical records of 136 patients with a variety of cancers that were treated with bevacizumab-based chemotherapy for metastatic disease. The presence of and changes in renal cysts were evaluated by retrospective analysis of computed tomography scans performed for assessment of tumor response to bevacizumab-based therapy.ResultsThe median age of the patients was 64 years. Renal cysts were identified in 66 patients, in whom 33 (50%) had a single cyst and the rest had 2 or more cysts. The average dose of bevacizumab was 2.68 mg/kg per week. Median duration of treatment was 33 weeks. Average cyst size was 1.9±2.4 cm at the beginning of the study and the majority of the cysts (54 patients, 84%) did not change in size or shape during bevacizumab treatment. No patients were identified with new cysts. Cyst size changed in 10 patients (16%): an increase of 15% to 40% from the baseline size in 5 patients and a decrease in size of 10% to 70% in another 5 patients. The duration of bevacizumab therapy was significantly longer in the subgroup of patients with diminished or increased cyst size than in the patients with stable cyst size: 62 weeks versus 29 weeks, respectively (p=0.0002).ConclusionsOur data demonstrated that simple renal cysts were stable in size and number in the vast majority of cancer patients treated with bevacizumab.

Surgical margin does not influence recurrence rate in pT1 clear cell renal cell carcinoma after partial nephrectomy: A multicenter study

“…Approval for the study was obtained from the relevant institutional review boards of each participating center. A database of 7,047 patients with RCC who underwent either RN or PN between 1999 and 2011 at eight academic centers was collected . The database listed patient characteristics including age, gender, body mass index (BMI), comorbidities (diabetes and hypertension), Eastern Cooperative Oncology Group (ECOG) performance status, surgical approach (open vs. laparoscopic), imperative indication for nephron‐sparing surgery (NSS; renal insufficiency, a solitary kidney, or a bilateral renal tumor), clinical tumor characteristics (tumor location, cTNM stage), tumor pathology (size, pTN stage, nuclear grade, histologic subtype, lymphovascular invasion, and surgical margin status), disease recurrence and site of recurrence (local or metastatic), and information on deaths and their causes.…”