Is There an Association between Advanced Stage of Renal Cell Carcinoma and Paraneoplastic Syndrome?

Ding, Guanxiong; Song, Ninghong; Feng, Chenchen; Xia, Guowei; Jiang, Haowen; Hua, Liang; Ding, Qiang

doi:10.1159/000334873

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…Moreover, varicocele, whether acute, symptomatic or an incidental finding, is almost never a sole feature of a renal or retroperitoneal tumour and some other features of the tumour are usually evident from the history or examination. Ding et al reported a retrospective analysis which included 1028 patients with pathologically confirmed unilateral RCC [ 154 ]. In 333 patients, paraneoplastic signs were present as the initial symptoms comprising pyrexia in 175 cases (52.6%), anaemia in 146 cases (43.8%), hypertension in 101 cases (30.3%), and varicocele in 12 cases (3.6%).…”

Section: Systematic Review To Address Question 14mentioning

confidence: 99%

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

et al. 2020

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Although often asymptomatic and detected incidentally, varicocele is a relatively common problem in patients who seek medical attention for infertility problems. Ultrasound (US) is the imaging modality of choice for evaluation, but there is no consensus on the diagnostic criteria, classification, and examination technique. In view of this uncertainty, the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology (ESUR-SPIWG) undertook a systematic review of the available literature on this topic, to use as the basis for evidence-based guidelines and recommendations. This paper provides the results of the systematic review on which guidelines were constructed.

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Section: Systematic Review To Address Question 14mentioning

confidence: 99%

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

et al. 2020

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“…Renal Cell Carcinoma is the third most common cancer of the genitourinary tract [ 1 ] and its incidence is increasing in the United States [ 2 ]. The clear cell variant of Renal Cell Carcinoma (ccRCC) represents over 80% of all histologic subtypes of renal cancer [ 3 ], and is frequently associated with the development cachexia symptoms [ 4 , 5 , 6 ]. Cachexia, a complex metabolic derangement characterized by skeletal muscle and fat loss develops in a significant number of patients with ccRCC.…”

Section: Introductionmentioning

confidence: 99%

The Combination of Low Skeletal Muscle Mass and High Tumor Interleukin-6 Associates with Decreased Survival in Clear Cell Renal Cell Carcinoma

Kays

Koniaris

Cooper

et al. 2020

Cancers

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Clear cell renal carcinoma (ccRCC) is frequently associated with cachexia which is itself associated with decreased survival and quality of life. We examined relationships among body phenotype, tumor gene expression, and survival. Demographic, clinical, computed tomography (CT) scans and tumor RNASeq for 217 ccRCC patients were acquired from the Cancer Imaging Archive and The Cancer Genome Atlas (TCGA). Skeletal muscle and fat masses measured from CT scans and tumor cytokine gene expression were compared with survival by univariate and multivariate analysis. Patients in the lowest skeletal muscle mass (SKM) quartile had significantly shorter overall survival versus the top three SKM quartiles. Patients who fell into the lowest quartiles for visceral adipose mass (VAT) and subcutaneous adipose mass (SCAT) also demonstrated significantly shorter overall survival. Multiple tumor cytokines correlated with mortality, most strongly interleukin-6 (IL-6); high IL-6 expression was associated with significantly decreased survival. The combination of low SKM/high IL-6 was associated with significantly lower overall survival compared to high SKM/low IL-6 expression (26.1 months vs. not reached; p < 0.001) and an increased risk of mortality (HR = 5.95; 95% CI = 2.86–12.38). In conclusion, tumor cytokine expression, body composition, and survival are closely related, with low SKM/high IL-6 expression portending worse prognosis in ccRCC.

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“…Few studies have evaluated the effect of PNS on oncological outcomes after nephrectomy. Some studies found that pre-operative cachexia and weight loss were associated with more advanced tumors 3,13 , and more recently, a study by Moreira et al found that those with PNS undergoing nephrectomy had significantly worse cancer specific and disease free survival owing to adverse pathologic features 14 . Similar to other studies, we found that patients with pre-operative PNS were more likely to have advanced tumor stage and grade (p<0.0001) compared to those without.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of paraneoplastic syndromes on patients with non-metastatic renal cell carcinoma undergoing surgery: Results from Canadian Kidney Cancer information system

Sun

Breau

Mallick

et al. 2020

CUAJ

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Introduction: The impact of paraneoplastic syndromes (PNS) on survival in patients with renal cell carcinoma (RCC) is uncertain. This study was conducted to analyze the association of PNS with recurrence and survival of patients with non-metastatic RCC undergoing nephrectomy. Methods: The Canadian Kidney Cancer information system is a multi-institutional cohort of patients started in January 2011. Patients with nephrectomy for non-metastatic RCC were identified. PNS included anemia, polycythemia, hypercalcemia, and weight loss. Associations between PNS and recurrence or death were assessed using Kaplan-Meier curves and multivariable analysis. Results: Of 4337 patients, 1314 (30.3%) had evidence of one or more PNS. Patients with PNS, were older, had higher comorbidity, and had more advanced clinical and pathological tumor characteristics as compared to patients without PNS (all p<0.05). Kaplan-Meier five-year estimated recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were significantly worse in patients with PNS (63.7%, 84.3%, and 79.6%, respectively for patients with PNS vs. 73.9%, 90.8%, and 90.1%, respectively for patients without PNS, all p<0.005). On univariable analysis, presence of PNS increased risk of recurrence (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.48–1.90, p<0.0001) and cancer-related death (HR 1.85, 95% CI 1.34–2.54, p=0.0002). Adjusting for known prognostic factors, PNS was not associated with recurrence or survival. Conclusions: In non-metastatic RCC patients undergoing surgery, presence of PNS is associated with older age, higher Charlson comorbidity index score, advanced tumor stage, and aggressive tumor histology. Following surgery, baseline PNS is not strongly independently associated with recurrence or death.

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Is There an Association between Advanced Stage of Renal Cell Carcinoma and Paraneoplastic Syndrome?

Cited by 13 publications

References 32 publications

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

The Combination of Low Skeletal Muscle Mass and High Tumor Interleukin-6 Associates with Decreased Survival in Clear Cell Renal Cell Carcinoma

Prognostic impact of paraneoplastic syndromes on patients with non-metastatic renal cell carcinoma undergoing surgery: Results from Canadian Kidney Cancer information system

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