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Active surveillance kidney cancer

Ericka M Sohlberg, Thomas J Metzner, John T Leppert
Overdiagnosis and overtreatment refer to the detection and treatment of conditions that would not ultimately affect an individual's health. With increasing detection of small renal masses there is growing awareness of the overdiagnosis and overtreatment of these tumors, supported by studies showing that 15-30% of nephrectomy specimens are pathologically benign, and that many small renal cell carcinomas are indolent. The harms of overdiagnosis and overtreatment are numerous, including psychosocial stressors and renal morbidity, in addition to unnecessary surgical complications...
March 21, 2019: European Urology Focus
Alireza Aminsharifi, Ross Simon, Thomas J Polascik, Cary N Robertson, Debra L Sudan, Bradley H Collins, Judd W Moul
PURPOSE: Current trends in renal transplantation such as improvement of allograft/ recipient survivals and expansion of organ transplantation eligibility criteria into older recipients are concomitant with increasingly detected low risk prostate cancer (PCa) in candidates for or recipients of renal transplantation. We review the evidence regarding PCa screening, diagnosis and management in renal transplant candidates and recipients. We focus on published reports regarding incidence and diagnosis of PCa in patients with End Stage Renal Disease (ESRD), pretransplant screening recommendations and recommendations regarding waiting time between treatment and active wait listing after the diagnosis of PCa in renal transplant candidates...
March 5, 2019: Journal of Urology
Richard E Gray, Gabriel T Harris
Kidney cancer is one of the 10 most common cancers in the United States with 90% being attributed to renal cell carcinoma. Men, especially black men, are more likely to be affected than women. Renal masses, either cystic or solid, are best detected with contrast-enhanced, triple-phase computed tomography. Renal tumors are often detected incidentally during a computed tomography scan of the abdomen or chest that was ordered for unrelated symptoms. Hematuria serves as a warning sign that necessitates further evaluation and imaging leading to a diagnosis and treatment plan...
February 1, 2019: American Family Physician
Yi Gao, Amanda R Twigg, Ryutaro Hirose, Garrett R Roll, Amy S Nowacki, Edward V Maytin, Allison T Vidimos, Raja Rajalingam, Sarah T Arron
Importance: Risk factors for the development of skin cancer after solid-organ transplant can inform clinical care, but data on these risk factors are limited. Objective: To study the association between HLA antigen mismatch and skin cancer incidence after solid-organ transplant. Design, Setting, and Participants: This retrospective cohort study is a secondary analysis of the multicenter Transplant Skin Cancer Network study of 10 649 adults who underwent a primary solid-organ transplant between January 1, 2003, and December 31, 2003, or between January 1, 2008, and December 31, 2008...
January 23, 2019: JAMA Dermatology
Mark C Markowski, Stephen A Boorjian, Jeremy P Burton, Noah M Hahn, Molly A Ingersoll, Saman Maleki Vareki, Sumanta K Pal, Karen S Sfanos
CONTEXT: The recent discovery of the existence of a human genitourinary microbiome has led to the investigation of its role in mediating the pathogenesis of genitourinary malignancies, including bladder, kidney, and prostate cancers. Furthermore, although it is largely recognized that members of the gastrointestinal microbiota are actively involved in drug metabolism, new studies demonstrate additional roles and the potential necessity of the gastrointestinal microbiota in dictating cancer treatment response...
January 14, 2019: European Urology
Farhad Islami, Ann Goding Sauer, Susan M Gapstur, Ahmedin Jemal
Importance: Excess body weight (EBW) is an established cause of cancer. Despite variations in the prevalence of EBW among US states, there is little information on the EBW-related cancer burden by state; this information would be useful for setting priorities for cancer-control initiatives. Objective: To calculate the population attributable fraction (PAF) of incident cancer cases attributable to EBW among adults 30 years or older in 2011 to 2015 in all 50 states and the District of Columbia...
December 27, 2018: JAMA Oncology
Mohit Gupta, Ridwan Alam, Hiten D Patel, Alice Semerjian, Michael A Gorin, Michael H Johnson, Peter Chang, Andrew A Wagner, James M McKiernan, Mohamad E Allaf, Phillip M Pierorazio
INTRODUCTION: A number of patients who elect active surveillance of their small renal masses (≤4 cm) subsequently pursue delayed intervention (DI). The indications, timing, and rates of DI have not been well determined prospectively. MATERIALS AND METHODS: Data from Delayed Intervention and Surveillance for Small Renal Masses, a prospective, multi-institutional registry was utilized to evaluate factors associated with DI between 2009 and 2018. RESULTS: Of 371 patients enrolled in AS, 46 (12...
November 13, 2018: Urologic Oncology
Alejandro Sanchez, Adam S Feldman, A Ari Hakimi
Renal cancer represents 2% to 3% of all cancers, and its incidence is rising. The increased use of ultrasonography and cross-sectional imaging has resulted in the clinical dilemma of incidentally detected small renal masses (SRMs). SRMs represent a heterogeneous group of tumors that span the full spectrum of metastatic potential, including benign, indolent, and more aggressive tumors. Currently, no composite model or biomarker exists that accurately predicts the diagnosis of kidney cancer before treatment selection, and the use of renal mass biopsy remains controversial...
October 29, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
M Gandini, C Scarinzi, S Bande, G Berti, P Carnà, L Ciancarella, G Costa, M Demaria, S Ghigo, A Piersanti, M Rowinski, T Spadea, M Stroscia, E Cadum
BACKGROUND: The LIFE MED HISS project aims at setting up a surveillance system on the long term effects of air pollution on health, using data from National Health Interview Surveys and other currently available sources of information in most European countries. Few studies assessed the long term effect of air pollution on hospital admissions in European cohorts. OBJECTIVE: The objective of this paper is to estimate the long term effect of fine particulate matter (PM2...
October 23, 2018: Environment International
Ryan D Ward, Hajime Tanaka, Steven C Campbell, Erick M Remer
Renal cell carcinoma (RCC) is a common cancer that is increasing in incidence because of the increased prevalence of risk factors, including tobacco use, hypertension, and obesity, and the improved detection of these tumors due to increased use of imaging. Localized renal cancer now accounts for more than 60%-70% of new RCC cases. Renal masses suggestive of cancer include enhancing solid renal lesions and Bosniak III and IV complex cystic lesions. Most of these tumors are detected incidentally, and many are slow growing with little propensity to metastasize...
November 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Qiang Fu, Le Xu, Yiwei Wang, Qi Jiang, Zheng Liu, Junyu Zhang, Quan Zhou, Han Zeng, Shanyou Tong, Tao Wang, Yangyang Qi, Baoying Hu, Hangcheng Fu, Huyang Xie, Lin Zhou, Yuan Chang, Yu Zhu, Bo Dai, Weijuan Zhang, Jiejie Xu
BACKGROUND: Glutamine addiction is a hallmark of clear cell renal cell carcinoma (ccRCC); yet whether glutamine metabolism impacts local immune surveillance is unclear. This knowledge may yield novel immunotherapeutic opportunities. OBJECTIVE: To seek a potential therapeutic target in glutamine-addicted ccRCC. DESIGN, SETTING, AND PARTICIPANTS: Tumors from ccRCC patients from a Shanghai cohort and ccRCC tumor data from The Cancer Genome Atlas (TCGA) cohort were analyzed...
October 4, 2018: European Urology
Cheryl E Peters, Marie-Élise Parent, Shelley A Harris, Linda Kachuri, Lidija Latifovic, Laura Bogaert, Paul J Villeneuve
OBJECTIVE: Previous studies considered the role of occupational causes in kidney cancer but were limited by small sample sizes and imprecise exposure assessment. This study examined the relationship between occupational exposure to asbestos and the risk of kidney cancer across a range of jobs in a large, population-based case-control study in Canada. METHODS: Data were from the case-control component of the National Enhanced Cancer Surveillance System, a study conducted between 1994 and 1997 in eight Canadian provinces...
August 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Arun Kadamkulam Syriac, Murtaza Mirza, Ashley Rose Malekunnel, Alberto Locante, Palak Desai
Thyroid malignancies are one of the fastest growing cancers in the world, with the majority being papillary thyroid cancer. Follicular variant of papillary thyroid cancer accounts for about 10%-20% of papillary thyroid carcinomas. The usual sites for metastases of these tumours are lungs and bones with renal metastases being extremely rare. We describe a case of a 64-year-old woman who presented with abdominal pain. On subsequent imaging, she was found to have a colonic mass with metastatic lesions in the lungs and tumour involving left kidney...
August 9, 2018: BMJ Case Reports
Jaime O Herrera-Caceres, Antonio Finelli, Michael A S Jewett
CONTEXT: Renal tumor biopsy (RTB), as distinct from the more common renal biopsy for medical renal disease, is an option for patients with renal masses. It is mainly used for small renal masses (SRM) but it may also be indicated for larger masses and even in the presence of metastatic disease. Its main indication in SRM is to avoid intervention for benign kidney tumors but increasingly enables more personalized treatment for kidney cancer patients. OBJECTIVE: The objective of this paper is to provide a comprehensive review of the most recent literature available for RTB including the indications, the technique and also the possible complications...
July 18, 2018: World Journal of Urology
Bimal Bhindi, R Houston Thompson, Christine M Lohse, Ross J Mason, Igor Frank, Brian A Costello, Aaron M Potretzke, Robert P Hartman, Theodora A Potretzke, Stephen A Boorjian, John C Cheville, Bradley C Leibovich
BACKGROUND: While the probability of malignant versus benign histology based on renal tumor size has been described, this alone does not sufficiently inform decision-making in the modern era since indolent malignant tumors can be managed with active surveillance. OBJECTIVE: To characterize the probability of aggressive versus indolent histology based on radiographic tumor size. DESIGN, SETTING, AND PARTICIPANTS: We evaluated patients who underwent radical or partial nephrectomy at Mayo Clinic for a pT1-2, pNx/0, M0 solid renal tumor between 1990 and 2010...
October 2018: European Urology
Yong Liu, Anne G Wheaton, Janet B Croft, Fang Xu, Timothy J Cunningham, Kurt J Greenlund
OBJECTIVES: To assess the association between sleep duration and health-related quality of life (HRQOL) among adults with or without chronic conditions. METHODS: Using the 2014 Behavioral Risk Factor Surveillance System, we analyzed self-reported data from adult respondents aged ≥18 years with (n=277,757, unhealthy group) and without (n=172,052. healthy group) reported history of any of nine chronic conditions (coronary heart disease, stroke, cancer, chronic obstructive pulmonary disease, diabetes, asthma, arthritis, depression, chronic kidney disease)...
June 2018: Sleep Health
Andrew G McIntosh, Benjamin T Ristau, Karen Ruth, Rachel Jennings, Eric Ross, Marc C Smaldone, David Y T Chen, Rosalia Viterbo, Richard E Greenberg, Alexander Kutikov, Robert G Uzzo
BACKGROUND: Active surveillance (AS) has gained acceptance as a management strategy for localized renal masses. OBJECTIVE: To review our large single-center experience with AS. DESIGN, SETTING, AND PARTICIPANTS: From 2000 to 2016, we identified 457 patients with 544 lesions managed with AS from our prospectively maintained kidney cancer database. A subset analysis was performed for patients with ≥5-yr follow-up without delayed intervention (DI)...
August 2018: European Urology
J R Pharr, C A Coughenour, T J Bungum
OBJECTIVE: Obesity and physical inactivity are associated with increased rates of chronic diseases and conditions. However, the 'fit but fat' theory posits that cardiopulmonary fitness (or physical activity) can mitigate risks to health associated with obesity. The purpose of this study was to compare chronic diseases and conditions of highly active/obese women with inactive/normal weight women. STUDY DESIGN: This was a cross-sectional study of the 2015 Behavioral Risk Factor Surveillance System data...
March 2018: Public Health
Todd M Morgan, Rohit Mehra, Placede Tiemeny, J Stuart Wolf, Shulin Wu, Zaina Sangale, Michael Brawer, Steven Stone, Chin-Lee Wu, Adam S Feldman
BACKGROUND: There is a critical need for improved prognostic discrimination in patients with renal cell carcinoma (RCC) given the increasing awareness that some patients may be managed with active surveillance, while others with higher-risk disease might benefit from adjuvant therapy following surgery. OBJECTIVE: To determine whether a multigene proliferation signature predicts long-term oncologic outcomes in surgically resected RCC. DESIGN, SETTING, AND PARTICIPANTS: The cell cycle proliferation (CCP) score was determined after radical nephrectomy for localized clear cell, papillary, or chromophobe RCC in 565 patients...
May 2018: European Urology
Giancarlo Marra, Marco Oderda, Marco Allasia, Stefania Munegato, Steven Joniau, Paolo Gontero
Despite the rise of small renal tumour (SRMs) diagnosis and related surgeries, death rate of kidney cancer is increasing, suggesting a non-optimal management of SRMs. Active Surveillance (AS) for kidney cancer was introduced to face this paradox. However, incertitude remains on whether and when AS can replace surgery in selected patients. We performed a literature search, reviewed and discussed the evidence in favour of AS or surgery for SRMs. Histopathology and natural history of SRMs, including the percentage of benign tumours amongst SRMs, tumour growth rate, life expectancy of SRMs patients being generally older, and current results of AS series seem to support its use in selected groups...
November 13, 2017: Anti-cancer Agents in Medicinal Chemistry
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