Introduction: How renal mass biopsy (RMB) impacts patient management with T1 renal masses (T1RMs) is unclear. We explore the association between RMB and utilization of active surveillance (AS), nephron-sparing interventions, and radical nephrectomy (RN).
Methods: Data were analyzed retrospectively using the MUSIC-KIDNEY (Michigan Urological Surgery Improvement Collaborative Kidney Mass: Identifying and Defining Necessary Evaluation and Therapy) registry.
Objective: Life expectancy models are useful tools to support clinical decision-making. Prior models have not been used widely in clinical practice for patients with renal masses. We sought to develop and validate a model to predict life expectancy following the detection of a localized renal mass suspicious for renal cell carcinoma.
View Article and Find Full Text PDFMetastasis of renal cell carcinoma (RCC) to the vaginal wall has rarely been reported in the literature. We present a case of a 48-year-old who was found to have a solitary RCC metastasis at the vaginal wall, five years following radical nephrectomy. This case is noteworthy because this late presentation is unique, with prior reports of synchronous metastasis or metastasis within two years of nephrectomy, highlighting the need to consider metastatic RCC to the vagina a possibility even many years after treatment.
View Article and Find Full Text PDFObjective: Understanding the relationship between comorbidities and life expectancy is important in cancer patients who carry risks of cancer and noncancer-related mortality. Comorbidity indices (CI) are tools to provide an objective measure of competing risks of death. We sought to determine which CI might be best incorporated into clinical practice for patients with suspected renal cancer.
View Article and Find Full Text PDFBackground: Paraneoplastic syndromes (PNS) are defined as the signs and symptoms attributed to cytokines or hormones released from a tumor or a patient's immune system. PNS have been reported with many cancers for decades and data supporting their relevance in renal cell carcinoma (RCC) are largely historical. The widespread use of electronic medical record (EMR) systems provides a more robust method to capture data.
View Article and Find Full Text PDFMetastasis of renal cell carcinoma (RCC) to the bladder is rare. We present a case of a 74-year-old patient with a metachronous, solitary metastasis of RCC to the bladder twenty months after partial nephrectomy and JJ-stent placement for a complex renal tumor. The mechanism of RCC metastasis to the bladder remains controversial, and we believe this case adds support to the drop metastasis theory.
View Article and Find Full Text PDFMice deficient in GHR (growth hormone receptor; KO) have a dramatic lifespan extension and elevated levels of hepatic chaperone-mediated autophagy (CMA). Using quantitative proteomics to identify protein changes in purified liver lysosomes and whole liver lysates, we provide evidence that elevated CMA in KO mice downregulates proteins involved in ribosomal structure, translation initiation and elongation, and nucleocytosolic acetyl-coA production. Following up on these initial proteomics findings, we used a cell culture approach to show that CMA is necessary and sufficient to regulate the abundance of ACLY and ACSS2, the two enzymes that produce nucleocytosolic (but not mitochondrial) acetyl-coA.
View Article and Find Full Text PDFChaperone-mediated autophagy (CMA) is the most selective form of lysosomal proteolysis, where individual peptides, recognized by a consensus motif, are translocated directly across the lysosomal membrane. CMA regulates the abundance of many disease-related proteins, with causative roles in neoplasia, neurodegeneration, hepatosteatosis, and other pathologies relevant to human health and aging. At the lysosomal membrane, CMA is inhibited by Akt-dependent phosphorylation of the CMA regulator GFAP.
View Article and Find Full Text PDFChaperone-mediated autophagy (CMA) is the most selective form of lysosomal proteolysis. CMA modulates proteomic organization through selective protein degradation, with targets including metabolic enzymes, cell growth regulators, and neurodegeneration-related proteins. CMA activity is low in -fed rodents but is increased by prolonged fasting.
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