Survivin Expression in Renal Cell Carcinoma

European Urology Supplements, 2012

1. 2. Frequency RCC overall accounts for 2% of all adult malignancies [7]. Worldwide, based on probably incomplete figures, about 270 000 new cases are diagnosed per year, and about 116 000 patients die per year [8]. In the United States alone, 58 000 new RCC cases were diagnosed in 2010, and approximately 13 000 patients died of RCC in the same year [7,9]. This corresponds to 65 000 new RCC cases per year in the European Union with >25 000 RCC deaths every year [10].

The Lancet Oncology, 2015

the genitourinary neoplasm with the highest mortality rate despite primary surgical treatment, which highlights the necessity for adjuvant treatment.

Urologia Internationalis, 2011

Renal cell carcinoma (RCC) comprises up to 85% of renal malignancies in adults and about 70% of these are of the clear-cell subtype (ccRCC) . Despite the established role of radical nephrectomy as the standard of care in past decades, at present nephron-sparing techniques including partial nephrectomy are established options with the advantage of conferring excellent oncological outcome while preserving renal function .

Cancer therapy & Oncology International Journal, 2017

Renal cell carcinoma is one of the most diverse cancers in terms of its natural biology and a leading cause of cancer-related death. All experts agree that a clinical trial, if available, should be considered as a first option for any patient with advanced renal cell carcinoma. Managing advanced renal cell carcinoma has become far more complex. With the availability of multiple new agents and additional targeted therapies on the horizon, selecting the optimal treatment and optimal sequence of treatments, for individual patients with metastatic renal cell carcinoma has become more challenging for clinicians. This article explores the patient-and disease-related factors that should be considered when planning mRCC treatment and discusses the latest clinical evidence for available therapeutic options.

Journal of Urology, 2009

Introduction-S8949 demonstrated improved overall survival (OS) for palliative debulking nephrectomy in interferon-treated patients with advanced renal cell carcinoma (RCC). We updated the primary analysis of S8949, now with a median follow-up time of 9 years, and explored clinical predictors of OS. Methods-Univariate and multivariate Cox regression analyses were performed to evaluate the impact of clinical variables potentially influencing survival, including early progression within 90 days (PD) and performance status (PS), among others. Results-Two hundred forty six patients with advanced or metastatic RCC were randomized to interferon with or without nephrectomy. Of 241 eligible patients, median age was 59 years, 167 (69%) were male and 125 (52%) had PS 1. Patients randomized to nephrectomy had improved OS (hazard ratio [HR] 0.74, 95% CI 0.57-0.96 p=0.022), confirming the original report. Univariate analysis showed PS=1 (p<0.0001), hemoglobin below the median (p=0.015), and early PD within 90 days (p<0.0001) as poor prognostic factors. Multivariate analysis showed PS 1 vs. 0 (HR 1.95, p<0.0001), high alkaline phosphatase (HR 1.5, p=0.002) and lung metastases only (HR 0.73, p=0.028) as OS predictors. There was no evidence of an interaction of PS, hemoglobin or lung metastases with nephrectomy (all P>0.20). In a patient subset surviving at least 90 days postrandomization, early PD was also a significant predictor of survival in a multivariate model (HR 2.1, p<0.0001) as was PS (HR 1.7, p=0.0006). Conclusions-Nephrectomy prolongs long-term OS in this updated analysis, supporting its role as standard therapy for advanced RCC patients. The benefit from nephrectomy was seen across all pre-specified patient subsets. Early PD (within 90 days) and PS were strong predictors of OS. These results support current efforts to identify biomarkers of RCC treatment resistance and early PD to facilitate rational patient selection for systemic therapy.

Annals of Diagnostic Pathology, 2009

On the basis of the National Cancer Data Base (NCDB), we describe the disease characteristics and use of conventional prognostic parameters in a hospital-based cohort of pathologically confirmed renal cell carcinomas (RCCs). Between 1993 and 1998, the NCDB obtained 149 424 cases of kidney (and renal pelvis) cancers from registries all over the United States. This database was queried for 47 909 histologically specified RCCs. Survival outcome was analyzed based on conventional clinical and pathologic parameters reported to the database (up to 2003). Renal cell carcinoma was more common in men (male-female ratio = 1.6:1). The mean age was 62.6 years. Most (66.6%) were organ-confined (stage I/II) at the time of diagnosis. The mean tumor size was 6.49 cm. The 5-year observed survival of RCC was 62.9% for male and 68.1% for female and was 81.0% for younger than 40 years old and 64.2% for older than 40 years old. The 5-year observed survival of RCC patients by the fifth edition 1997 American Joint Committee on Cancer TNM staging were stages I, 77.8%; II, 72.8%; III, 55.0%; and IV, 16.9%, demonstrating a dramatic decline in patient survival at stage IV. By reported pathologic grade, significant stratification was achieved in the observed survival for RCC overall irrespective of histologic subtypes (grade 1, 77.8%; 2, 69.6%; 3, 48.8%; and 4, 35.3% 5-year observed survival). These large NCDB data in RCC confirm the importance of pathologic evaluation of traditional prognostic parameters of stage and grade in RCC and is a powerful resource in defining cancer patient characteristics and analysis of prognostic variables that helps influence future cancer care planning and resource allocation.

Cancer research, 1997

to the investigation of a variety of other immunotherapeutic ap proaches for treating metastatic RCC. At a recent symposium held in September 1996 in Washington, D.C. and sponsored by the National Cancer Institute,clinicians and researchers convened to discuss recent progress and future directions in the diagnosis and treatment of RCC. Presentations focused on two areas of active research: (a) understanding the molecular genetics and biology of RCC; and (b) new immunotherapeutic strategies. Recent

Asian Pacific journal of cancer prevention : APJCP, 2013

Renal cell carcinomas make up 3% of all cancers and one in four patients is metastatic at time of diagnosis. This cancer is one of the most resistant to cytotoxic chemotherapy. Studies have shown that the efficiency of interferon-alpha and/or interleukin-2 based immune therapies is limited in patients with metastatic renal cell carcinoma but latest advances in molecular biology and genetic science have resulted in better understanding of its biology. Tumor angiogenesis, tumor proliferation and metastasis develop by the activation of signal message pathways playing a role in the development of renal cell carcinomas. Better definition of these pathways has caused an increase in preclinic and clinical studies into target directed treatment of renal cell carcinoma. Many recent studies have shown that numerous anti-angiogenic agents have marked clinical activity. In this article, the focus is on general characteristics of molecular pathways playing a major role in renal cell carcinoma, r...

Journal of clinical …, 1999

RESULTS: The median survival time was 10 months (95% confidence interval [CI], 9 to 11 months). Fifty-seven of 670 patients remain alive, and the median follow-up time for survivors was 33 months. Pretreatment features associated with a shorter survival in the ...

The Oncologist, 2011

In the past 15 years, there has been an increased understanding of the tumor biology of renal cell carcinoma (RCC). The identification of vascular endothelial growth factor (VEGF), its related receptor (VEGFR), and the mammalian target of rapamycin as dysregulated signaling pathways in the development and progression of RCC has resulted in the rational development of pharmaceutical agents capable of specifically targeting key steps in these pathways. Clinical trials have demonstrated survival benefit with these agents, particularly in clear cell RCC patients. However, metastatic RCC will progress in all patients, resulting in a critical need to determine patient risk and optimize treatment. The goal of this article is to highlight the significant breakthroughs made in understanding the critical genetic alterations and signaling pathways underlying the pathogenesis of RCC. The discovery of prognostic factors and development of comprehensive nomograms to stratify patient risk and predictive biomarkers to facilitate individualized treatment selection and predict patient response to therapy also are reviewed.

European Journal of Cancer Care, 2010

The purpose of the present study is to evaluate the prognostic factors of patients with renal cell carcinoma. The treatment results such as distant metastasis-free survival and overall survival of 59 previously untreated patients were retrospectively analysed. Median follow-up was 17.5 months (3.8-88.5 months). Overall survival was 22.4 months (3-87 months). Distant metastasis developed in 35 (59%) patients. The Eastern Cooperative Oncology Group (ECOG) performance status (P = 0.022), tumour size (P = 0.025) and lymphatic invasion (P < 0.0001) were significantly effective prognostic factors for distant metastasis-free survival on multivariate analysis. Related to overall survival, gender (P = 0.025), ECOG performance status (P = 0.027), nuclear grade (P = 0.002), tumour size (P = 0.029), T stage (P = 0.044), nodal involvement (P = 0.003), surgical margin (P = 0.046), renal sinus invasion (P < 0.0001), perineural growth (P = 0.001) and lymphatic invasion (P < 0.0001) were significant prognostic factors on univariate analysis. Gender (P = 0.008), ECOG performance status (P = 0.027), tumour size (P = 0.025) and lymphatic invasion (P < 0.0001) retained their significance on multivariate analysis. We concluded that the most important prognostic factors for patients with renal cell carcinomas are ECOG performance status, tumour size and lymphatic invasion.

Introduction and objective: Clear-cell renal-cell carcinoma (RCCcc) is the genitourinary neoplasm with the highest mortality rate despite primary surgical treatment, which highlights the necessity for adjuvant treatment. To date, only the use of sunitinib in the S-TRAC study (Adjuvant Sunitinib in High-Risk Renal-Cell Carcinoma after Nephrectomy) has shown improvement of disease-free survival (DFS). The aim of the present study is to identify, using a single-center sample of patients with locally advanced RCC, potential candidates for adjuvant treatment by the application of the S-TRAC criteria. Material and methods: We enrolled patients undergoing oncological nephrectomy from 2009 to 2014. We selected and stratified the patients according to the S-TRAC criteria. DFS and overall survival (OS) were analyzed. Results: Forty-eight patients out of the 153 (31.4%) previously selected patients met the S-TRAC inclusion criteria. DFS and OS at 5 years were 73.0% and 71.4%, respectively. According to the UISS prognostic model, 85.4%, 4.1% and 6.2% of our patients were assigned to groups A2, B and C, respectively. DFS in these groups was 73%, 100% and 100%, respectively. OS was 76% in group A2 and 67% in group C. No deaths were observed in group B.

World Journal of Oncology

Background: Due to the infrequency of non-clear cell renal cell carcinoma (RCC), there is currently a paucity of high-quality literature to help guide the effective treatment of these tumors. Recently, biomarkers such as platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic immune inflammation (SII) index and C-reactive protein to albumin ratio (CAR) have been demonstrated to be closely related to poor prognosis of patients with RCC. The objective of this study was to evaluate these biomarkers for determining the progression-free survival (PFS) and overall survival (OS) in patients with metastatic non-clear cell cancer. Methods: We retrospectively reviewed 31 cases diagnosed with metastatic non-clear cell RCC from January 2012 to December 2017. We assessed the prognostic value (OS and PFS) of pretreatment PLR, LMR, SII index and CAR based on multivariate analysis and Kaplan-Meier survival curve. Results: Median time of OS and PFS were 15.5 months (95% confidence interval (CI): 13.7-15.2) and 10.9 months (95% CI: 8.9-12.8), respectively. The median PFS (0.001) and OS (P = 0.01) was shorter in patients with PLR > 171, LMR < 2.61. Moreover, median PFS but not OS was significantly lower in SII index > 883 (P = 0.064) and CAR > 0.11 (P = 0.229). Scan to surgery time (3.91 weeks, P = 0.001) was also significantly related to progression. Conclusions: Elevated pretreatment inflammatory biomarkers such as PLR, LMR, SII index and CAR are significant determinants of shorter PFS and OS (PLR and LMR only) in patients with metastatic non-clear cell RCC treated with cytoreductive nephrectomy.