Objective:The purpose of the study was to identify the best sequence of therapy beginning with a tyrosine kinase inhibitor(TKI)as the first-line therapy for patients with metastatic renal cell carcinoma(mRCC)in terms ...Objective:The purpose of the study was to identify the best sequence of therapy beginning with a tyrosine kinase inhibitor(TKI)as the first-line therapy for patients with metastatic renal cell carcinoma(mRCC)in terms of overall survival(OS),progression-free survival(PFS),and rates of discontinuation and adverse effects during the treatment period.Methods:This is a retrospective,nationwide multicenter study of patients with mRCC after diagnosis at 10 different tertiary medical centers in Korea from January 1992 to December 2017.We focused on patients at either“favorable”or“intermediate”risk according to the International mRCC Database Consortium criteria,and they were followed up(median 335 days).Finally,a total of 1409 patients were selected as the study population.We generated a Cox proportional hazard model adjusted for covariates,and the different therapy schemes were statistically tested in terms of OS as well as PFS.In addition,frequencies of discontinuation and adverse events were compared among the therapy schemes.Results:Of the primary patterns of treatment sequences(24 sequences),“sunitinib epazopanib”and“sunitinibeeverolimuseimmunotherapy”showed the most beneficial results in both OS and PFS with significantly lower hazards than“sunitinib”,which is the most commonly treated agent in Korea.Considering that the“TKIeTKI”structure showed relatively higher discontinuation rates with higher adverse effects,the overall beneficial sequence would be“sunitinibeeverolimuseimmunotherapy”.Conclusion:Among several sequential therapy starting with TKIs,“sunitinibeeverolimuse immunotherapy”was found to be the best scheme for mRCC patients with“favorable”or“intermediate”risks.展开更多
Clear cell papillary renal cell carcinoma(ccpRCC) was recently established as a distinct type of epithelial neoplasm by the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. He...Clear cell papillary renal cell carcinoma(ccpRCC) was recently established as a distinct type of epithelial neoplasm by the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. Here,we report a case of partial nephrectomy for a ccpRCC detected during the routine follow-up of a previously treated liposarcoma in a 70-year-old male patient. The patient was referred to the urology department for a right-sided renal mass(size: 2 cm)detected during routine annual imaging follow-up for a malignant right inguinal fibrous histocytoma and liposarcoma that had been diagnosed 6 and 4 years earlier,respectively,and treated with surgery and adjuvant radiation therapy.Following partial nephrectomy,the renal mass was pathologically diagnosed as ccpRCC,and immunohistochemistry revealed carbonic anhydrase 9(CA9)expression. No recurrences or metastases were detected on follow-up imaging for6 months. This is the first report of partial nephrectomy for incidentally discovered CA9-positive ccpRCC.展开更多
Prostate cancer is the second most common male cancer, with half of all patients going on to develop metastases. To better identify patients at high risk for prostate cancer progression and reduce prostate cancer-rela...Prostate cancer is the second most common male cancer, with half of all patients going on to develop metastases. To better identify patients at high risk for prostate cancer progression and reduce prostate cancer-related mortality, improved prognostic factors are required. In this study, we used immunohistochemistry （IHC） to determine the prognostic values of multiple tissue biomarkers in hormone-na＇l＇ve prostatectomy specimens of prostate cancer. Using 510 prostatectomy specimens collected between 2002 and 2012, IHC analysis was performed for Cerb-2, Cyclin D1, VEGF, EGFR, Rb, PSCA, p53, Bcl-2, Cox-2, PMS2, and Ki-67 on formalin-fixed paraffin-embedded sections. The Cox proportional hazard model was used to determine the predictive risk factors for biochemical recurrence （BCR） of prostate cancer. During a median 44-month follow-up, 128 （25.1%） patients developed BCR. A multivariate regression analysis revealed that Ki-67 （hazard ratio [HR]. 1.60, P = 0.033）, PSCA （HR： 0.42, P 〈 0.001）, and Cox-2 （HR： 2.05, P = 0.003） were the only significant prognostic tissue markers of BCR. Resection margin status （HR： 1.67, P = 0.010）, pathologic pTO/l/2 stage （vs pT3/4; HR： 0.20, P = 0.002）, preoperative PSA levels （HR.. 1.03, P 〈 0.001）, biopsied （HR： 1.30, P = 0.022） and pathologic （HR： 1.42, P = 0.005） Gleason scores, and prostate size （HR： 0.97, P = 0.003） were significant clinicopathologic factors. The expression of Ki-67, PSCA, and Cox-2 biomarkers along with other clinicopathologic factors were prognostic factors for BCR in patients with clinically localized prostate cancer following radical prostatectomy.展开更多
文摘Objective:The purpose of the study was to identify the best sequence of therapy beginning with a tyrosine kinase inhibitor(TKI)as the first-line therapy for patients with metastatic renal cell carcinoma(mRCC)in terms of overall survival(OS),progression-free survival(PFS),and rates of discontinuation and adverse effects during the treatment period.Methods:This is a retrospective,nationwide multicenter study of patients with mRCC after diagnosis at 10 different tertiary medical centers in Korea from January 1992 to December 2017.We focused on patients at either“favorable”or“intermediate”risk according to the International mRCC Database Consortium criteria,and they were followed up(median 335 days).Finally,a total of 1409 patients were selected as the study population.We generated a Cox proportional hazard model adjusted for covariates,and the different therapy schemes were statistically tested in terms of OS as well as PFS.In addition,frequencies of discontinuation and adverse events were compared among the therapy schemes.Results:Of the primary patterns of treatment sequences(24 sequences),“sunitinib epazopanib”and“sunitinibeeverolimuseimmunotherapy”showed the most beneficial results in both OS and PFS with significantly lower hazards than“sunitinib”,which is the most commonly treated agent in Korea.Considering that the“TKIeTKI”structure showed relatively higher discontinuation rates with higher adverse effects,the overall beneficial sequence would be“sunitinibeeverolimuseimmunotherapy”.Conclusion:Among several sequential therapy starting with TKIs,“sunitinibeeverolimuse immunotherapy”was found to be the best scheme for mRCC patients with“favorable”or“intermediate”risks.
文摘Clear cell papillary renal cell carcinoma(ccpRCC) was recently established as a distinct type of epithelial neoplasm by the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. Here,we report a case of partial nephrectomy for a ccpRCC detected during the routine follow-up of a previously treated liposarcoma in a 70-year-old male patient. The patient was referred to the urology department for a right-sided renal mass(size: 2 cm)detected during routine annual imaging follow-up for a malignant right inguinal fibrous histocytoma and liposarcoma that had been diagnosed 6 and 4 years earlier,respectively,and treated with surgery and adjuvant radiation therapy.Following partial nephrectomy,the renal mass was pathologically diagnosed as ccpRCC,and immunohistochemistry revealed carbonic anhydrase 9(CA9)expression. No recurrences or metastases were detected on follow-up imaging for6 months. This is the first report of partial nephrectomy for incidentally discovered CA9-positive ccpRCC.
文摘Prostate cancer is the second most common male cancer, with half of all patients going on to develop metastases. To better identify patients at high risk for prostate cancer progression and reduce prostate cancer-related mortality, improved prognostic factors are required. In this study, we used immunohistochemistry （IHC） to determine the prognostic values of multiple tissue biomarkers in hormone-na＇l＇ve prostatectomy specimens of prostate cancer. Using 510 prostatectomy specimens collected between 2002 and 2012, IHC analysis was performed for Cerb-2, Cyclin D1, VEGF, EGFR, Rb, PSCA, p53, Bcl-2, Cox-2, PMS2, and Ki-67 on formalin-fixed paraffin-embedded sections. The Cox proportional hazard model was used to determine the predictive risk factors for biochemical recurrence （BCR） of prostate cancer. During a median 44-month follow-up, 128 （25.1%） patients developed BCR. A multivariate regression analysis revealed that Ki-67 （hazard ratio [HR]. 1.60, P = 0.033）, PSCA （HR： 0.42, P 〈 0.001）, and Cox-2 （HR： 2.05, P = 0.003） were the only significant prognostic tissue markers of BCR. Resection margin status （HR： 1.67, P = 0.010）, pathologic pTO/l/2 stage （vs pT3/4; HR： 0.20, P = 0.002）, preoperative PSA levels （HR.. 1.03, P 〈 0.001）, biopsied （HR： 1.30, P = 0.022） and pathologic （HR： 1.42, P = 0.005） Gleason scores, and prostate size （HR： 0.97, P = 0.003） were significant clinicopathologic factors. The expression of Ki-67, PSCA, and Cox-2 biomarkers along with other clinicopathologic factors were prognostic factors for BCR in patients with clinically localized prostate cancer following radical prostatectomy.
