Renal cell carcinoma: The role of radical surgery on different patterns of local or distant recurrence

Franco, Gregorio Di; Palmeri, Matteo; Sbrana, Andrea; Gianardi, Desirée; Furbetta, Niccolò; Guadagni, Simone; Bianchini, Matteo; Stefanini, Gianni; Adamo, G.; Pollina, Luca Emanuele; Galli, Luca; Candio, Giulio Di; Morelli, Luca

doi:10.1016/j.suronc.2020.08.002

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…Unsurprisingly, the highest post-transplant renal cancer incidence and shortest interval between renal cancer diagnosis and transplantation were found in the RCC group. In fact, the 3% recurrence rate of renal cancer at the most recently reported follow-up in this study was higher than that of the general population isolated a local rare recurrence incidence of 1%–2% at 5-year follow-up ( 20 – 23 ). According to previous studies, the patient’s age, sex, race, and BMI did not significantly influence cancer recurrence ( 24 ).…”

Section: Discussioncontrasting

confidence: 57%

Transplant or dialysis: What’s the better choice for RCC-induced ESRD patients? A 20-year analysis of OPTN/UNOS data

Hao

Lai²,

Xia³

et al. 2022

Front. Oncol.

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PurposeThe incidence of end-stage renal disease (ESRD) caused by renal cell carcinoma (RCC) is increasing with the high prevalence of RCC as well as those with treatment-related renal function impairment. Worries about tumor recurrence after transplant-related immunosuppression hinder the recommendation of kidney transplantation for RCC-induced ESRD patients. However, no direct analysis has been performed to identify whether kidney transplantation can offer better survival than maintaining dialysis.Materials and methodsThis retrospective population-based cohort study was based on Organ Procurement and Transplantation Network data released in March 2021. Characteristics and outcomes were compared, including the patient and graft survival of candidates and recipients with RCC-induced ESRD etiology as well as other primary diseases.ResultsPatients with RCC-induced ESRD were older; more likely to be male, White, and obese; and more likely to have a history of diabetes and dialysis. They also had higher creatinine levels, more delayed graft function, more primary non-function, and higher Kidney Donor Profile Index score donors, compared with the glomerulonephritis (GN) group. While waiting, RCC candidates suffered the worst outcomes of all groups, a 44% (adjusted hazard ratio [aHR], 1.44 [1.27–1.62]) higher risk of removal than GN patients. After transplantation, RCC recipients demonstrated comparable patient survival and better graft survival (p=0.21 and p=0.13, respectively). Compared with still-waiting RCC patients, the RCC recipients who received kidney transplants had significantly better outcomes (13.6 [9.3–17.8] vs. 61 [52–68.4] %), decreasing the death or deteriorating risk by 84% (aHR, 0.16 [0.13–0.20]).ConclusionsPatients with RCC-induced ESRD can dramatically benefit from kidney transplantation. Hence, these patients should not be limited to transplantation by strict strategies or a delayed waiting time out of their malignancy history.

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Section: Discussioncontrasting

confidence: 57%

Transplant or dialysis: What’s the better choice for RCC-induced ESRD patients? A 20-year analysis of OPTN/UNOS data

Hao

Lai²,

Xia³

et al. 2022

Front. Oncol.

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“…Clear cell renal cell carcinoma (ccRCC) is a familiar subtype of RCC, accounting for approximately 75% of all RCC cases (Song et al, 2018;Wolf et al, 2020). Over the last few years, treatment of RCC has improved with advances in medical technology, but the prognosis of RCC patients remains poor due to its high recurrence and metastasis rate (Wu et al, 2014;Di Franco et al, 2020). Therefore, it's indispensable to further probe the molecular regulatory mechanism of the occurrence and development of RCC and provide new biomarkers for the targeted therapy.…”

Section: Introductionmentioning

confidence: 99%

HIF-1α Induces HECTD2 Up-Regulation and Aggravates the Malignant Progression of Renal Cell Cancer via Repressing miR-320a

Shen

Yao

et al. 2021

Front. Cell Dev. Biol.

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Renal cell carcinoma (RCC) is a frequent malignancy of the urinary system. It has been found that hypoxia mediates the malignant evolvement of RCC. Here, we probe the impact and potential mechanism of HECT domain E3 ubiquitin-protein ligase 2 (HECTD2) and HIF-1α on regulating RCC evolvement. RCC tissues and adjacent normal tissues were collected, and the association between the expression profiles of HECTD2 and HIF-1α and the clinicopathological features was analyzed. Additionally, we constructed HECTD2/HIF-1α overexpression and knockdown models in RCC cell lines to ascertain the impacts of HECTD2 and HIF-1α on RCC cell proliferation, apoptosis, migration, and growth in vivo. We applied bioinformatics to predict the upstream miRNA targets of HECTD2. Meanwhile, RNA immunoprecipitation (RIP), and the dual-luciferase reporter assays were employed to clarify the targeting association between HECTD2 and miR-320a. The effect of miR-320a on HECTD2-mediated RCC progression was investigated. The results suggested that both HIF-1α and HECTD2 were up-regulated in RCC (compared with adjacent non-tumor tissues), and they had positive relationship. Moreover, higher level of HECTD2 and HIF-1α is associated with poorer overall survival of RCC patients. HECTD2 overexpression heightened RCC cell proliferation and migration, and weakened cell apoptosis. On the other hand, the malignant phenotypes of RCC cells were signally impeded by HECTD2 or HIF-1α knockdown. Moreover, miR-320a targeted the 3′-untranslated region of HECTD2 and suppressed HECTD2 expression. The rescue experiments showed that miR-320a restrained HECTD2-mediated malignant progression in RCC, while up-regulation of HIF-1α hampered miR-320a expression. Collectively, HIF-1α mediated HECTD2 up-regulation and aggravated RCC progression by attenuating miR-320a.

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“…This pathology has been termed “continued tumor growth” and is detected within the first 6 months after surgery. 92 In continued growth, the primary and secondary tumors have the same histological subtype and location, which is confirmed by tumor cells in the granulomas around the sutures after the preceding surgery. Another mechanism is the microscopic spread of tumor cells of the primary tumor through blood or lymph, the so called “tumor micrometastasis.” This pathology is characterized by a single histological subtype of primary and recurrent tumors, as well as neoplastic emboli in the microvessels of the affected organ.…”

Section: Discussionmentioning

confidence: 82%

“…87 The development of locoregional recurrence after nephrectomy may result from micrometastatic involvement of surrounding body organs and tissues that were not removed during the primary surgery (ipsilateral adrenal, 87 regional lymph nodes, 6 perirenal cellular tissue, and renal bed 88 ). 92 This pathology is mainly determined by the biology of the tumor. The local recurrence after nephrectomy may also be caused by tumor growth as a defect in the surgical technique, similar to the case of continued growth after renal resection.…”

Section: Discussionmentioning

confidence: 99%

Markers of local kidney cancer recurrence: A surgeon’s mistake or a pattern? Review

et al. 2022

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The influence of various morphological, anatomical, genetic and other factors on the local recurrence-free survival of patients who have undergone different renal cell cancer (RCC) treatment is still a rather complex, ambiguous and controversial issue for practicing oncourologists. This review evaluates the effect of several factors on both recurrence-free survival and local recurrence-free survival. The review includes articles, clinical cases, literature reviews, and meta-analyses highlighting the analysis of independent and interrelated predisposing factors for developing local recurrence of RCC from 1984 to 2020. The PubMed, Web of Science, and Scopus databases were searched in English, Spanish, and German. A review of the literature showed the role of the following indices in the local recurrence RCC: microvascular invasion ( p = 0.001), tumor necrosis ( p = 0.0001), high malignancy (Fuhrman III or IV) (HR = 38.3, 95% CI 3.1–467, p = 0.004) as histological factors, tumor size as an anatomical factor. Thus, the authors state that every centimeter of the tumor increases the risk of local recurrence ( p < 0.05). A group from the Mayo Clinic showed the equivalence of different treatment methods in local RCC recurrence. Thus, in the group of patients with cT1a stage kidney cancer, the 5-year local recurrence-free survival rates were 97.7% (96.7–98.6), 95.9% (92.3–99.6), and 95.9% (92.3–99.6) for renal resection, RFA, and cryoablation, respectively. Surgical margin status is the most studied and controversial marker of local renal cell carcinoma recurrence. Researchers found a direct effect of PSM on the risk of local RCC recurrence ( p < 0.01). The personalized approach with the search and evaluation of predisposing factors for the local recurrence, as well as further selection of the most optimal treatment, will allow oncourologists to improve both the effectiveness of primary treatment and the recurrence-free survival of patients.

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Renal cell carcinoma: The role of radical surgery on different patterns of local or distant recurrence

Cited by 9 publications

References 23 publications

Transplant or dialysis: What’s the better choice for RCC-induced ESRD patients? A 20-year analysis of OPTN/UNOS data

Transplant or dialysis: What’s the better choice for RCC-induced ESRD patients? A 20-year analysis of OPTN/UNOS data

HIF-1α Induces HECTD2 Up-Regulation and Aggravates the Malignant Progression of Renal Cell Cancer via Repressing miR-320a

Markers of local kidney cancer recurrence: A surgeon’s mistake or a pattern? Review

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