Correlation of Ki-67 and gelsolin expression to clinical outcome in renal clear cell carcinoma.

Objectives: To analyze the expression levels of Ki-67 and gelsolin in renal cell carcinoma (RCC) and determine their prognostic value in association with other clinicopathologic factors using tissue microarray technology. Histologic nuclear grade, performance status, and clinical stage are important prognostic factors in RCC. Because patients with tumors of similar grade, performance status, and stage may show a wide variation in biologic behavior and clinical outcome, additional biomarkers for RCC are needed to provide further prognostic information and possibly offer insight into the mechanisms of the disease.

Phase I trial of granulocyte macrophage-colony stimulating factor and interleukin-4 as a combined immunotherapy for patients with cancer.

Antigen-presenting cells (APC), such as dendritic cells (DC), are the key component of many cancer immunotherapy strategies. However, DCs comprise a rare population of clinically obtainable cells and are compromised in function in cancer-bearing hosts. Clinical trials therefore rely upon DC generated ex vivo.

Number of metastatic sites rather than location dictates overall survival of patients with node-negative metastatic renal cell carcinoma.

Objectives: To perform a retrospective study to determine whether survival and immunotherapy response are related to the site of metastases (lung versus bone) and to the number of organ sites involved (one versus multiple). The most common sites of metastatic renal cell carcinoma (mRCC) are the lung and bone.

Methods: The records of 434 patients with mRCC were reviewed.

Renal cell carcinoma with tumor thrombus extension: biology, role of nephrectomy and response to immunotherapy.

Purpose: We outline the biology, prognosis and role of immunotherapy for renal cell carcinoma with gross venous tumor thrombus.

Materials And Methods: A total of 207 patients with unilateral renal cell carcinoma and tumor thrombus into the renal vein (107) and inferior vena cava (100) who underwent nephrectomy and thrombectomy were compared with 607 without tumor thrombus.

Results: At diagnosis 77 patients (37%) had N0M0 disease and 130 (63%) had lymph node (N+) or distant (M1) metastases.

TNM T3a renal cell carcinoma: adrenal gland involvement is not the same as renal fat invasion.

Purpose: Upper pole tumors with direct extension into the adrenal gland are currently staged as pT3a tumors in the 1997 TNM staging system. To determine whether the clinical behavior of pT3a adrenal tumors differs from that of tumors with perinephric fat invasion (also stage pT3a) a retrospective analysis was performed.

Materials And Methods: Of 1,087 patients who underwent nephrectomy 27 were identified with direct adrenal involvement and 187 were identified with perinephric fat or renal sinus involvement.

Carbonic anhydrase IX is an independent predictor of survival in advanced renal clear cell carcinoma: implications for prognosis and therapy.

Purpose: Metastatic renal cell carcinoma (RCC) has a poor prognosis and an unpredictable course. To date, there are no molecular markers which can reliably predict RCC outcome. We investigated whether a novel kidney cancer marker, carbonic anhydrase IX (CAIX), is associated with progression and survival.

Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma.

Purpose: To create a comprehensive algorithm that can predict postoperative renal cell carcinoma (RCC) patient outcomes and response to therapy.

Patients And Methods: A prospective cohort study was performed with outcome assessment on the basis of chart review of 814 patients who underwent nephrectomy between 1989 and 2000. At diagnosis, M1 or N1/N2M0 metastatic disease (M) was present in 346 patients (43%), whereas 468 patients had no metastatic disease (NM) (N0M0).

Renal cell carcinoma with tumor thrombus: is cytoreductive nephrectomy for advanced disease associated with an increased complication rate?

Purpose: We examined whether cytoreductive nephrectomy in patients with venous tumor thrombus and metastatic disease is associated with more complications than in those with thrombus without metastatic disease.

Materials And Methods: Between 1989 and 2000, 74 patients with renal vein extension, 87 with inferior vena caval extension and 491 without tumor thrombus underwent nephrectomy at our institution. Metastatic and nonmetastatic renal vein extension in 51 and 23 cases, inferior vena caval extension in 54 and 33, and nontumor thrombus in 171 and 320, respectively, were compared for symptoms at presentation, surgical data, mortality and complications.

Unclassified renal cell carcinoma: clinical features and prognostic impact of a new histological subtype.

Purpose: We characterized the histopathological features and clinical behavior of unclassified renal cell carcinoma and compared the prognostic outcome in patients with unclassified and conventional (clear cell) renal cell carcinoma.

Materials And Methods: A total of 31 patients with unclassified renal cell carcinoma are included in the kidney cancer database at our institution. Another 317 matched patients with clear cell carcinoma were used for comparing demographic, clinical, pathological and survival data.

Mathematical model to predict individual survival for patients with renal cell carcinoma.

Purpose: To develop a multivariate model and mathematical formula capable of calculating personalized survival for renal cell carcinoma (RCC) patients with clinically available variables.

Patients And Methods: A total of 477 patients out of 661 undergoing nephrectomy at the University of California Los Angeles between 1989 and 1999 were eligible for evaluation and formed the analyzed cohort for this retrospective study. Time to death was the primary end point assessed.

Collecting duct renal cell carcinoma: clinical study of a rare tumor.

Purpose: Collecting duct carcinoma is a rare type of renal cell carcinoma that affects younger patients, and is associated with aggressive regional and distant spread. The clinical and pathological features of 6 patients with collecting duct carcinoma treated at a single institution are described.

Materials And Methods: There were 6 patients with collecting duct carcinoma included in the University of California School of Medicine, Los Angeles, Kidney Cancer Database.