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[PMID]:29376614
[Au] Autor:Popkov VM; Tarasenko AI; Maslyakova GN; Rossolovskii AN; Berezinets OL
[Ad] Endereço:Saratov State Medical University n. a. V. I. Razumovsky, Saratov, Russia.
[Ti] Título:[A look at the problem of surgical treatment of renal cel carcinoma in the aspect of biomolecular diagnosis and assessment of renal function].
[So] Source:Urologiia;(6):153-159, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The article reviews the domestic and international literature on the issues of biomolecular diagnosis of acute renal injury in the perioperative period in patients with renal cell carcinoma (RCC). Emerging opportunities for early detection of tumors make even more relevant the use of minimally invasive interventions. Of equal importance is the assessment of renal function in patients with diagnosed RCC and the prediction of acute renal injury and progression of chronic kidney disease in the postoperative period. The authors performed a systematic search for preclinical and clinical studies to identify the main trends and achievements in the field of biomolecular diagnosis of RCC and renal injury allowing the individual approach to choosing surgical treatment, improve the survival and quality of life of the patient and improve the functional state of the renal parenchyma.
[Mh] Termos MeSH primário: Carcinoma de Células Renais
Neoplasias Renais
Laparoscopia/métodos
Nefrectomia/métodos
[Mh] Termos MeSH secundário: Carcinoma de Células Renais/diagnóstico
Carcinoma de Células Renais/metabolismo
Carcinoma de Células Renais/cirurgia
Seres Humanos
Neoplasias Renais/diagnóstico
Neoplasias Renais/metabolismo
Neoplasias Renais/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


  2 / 27689 MEDLINE  
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[PMID]:29429165
[Au] Autor:Zhou JX; He XR; Song GX; Zou ZG; Wang LH; Hu R; Li HX
[Ad] Endereço:Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
[Ti] Título:[Clinicopathologic features with collecting duct carcinoma of kidney: report of 10 cases].
[So] Source:Zhonghua Bing Li Xue Za Zhi;47(2):123-127, 2018 Feb 08.
[Is] ISSN:0529-5807
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To study the pathological features, immunophenotypes, differential diagnoses and prognostic parameters of collecting duct carcinoma of the kidney (CDC). Clinical imaging, histopathology, immunohistochemistry, and survival data of 10 patients at First Affiliated Hospital of Nanjing Medical University from January 2009 to August 2017 were retrospectively analyzed along with a review of literatures. The clinical symptoms of CDC were not specific, and image examinations showed space-occupying mass lesions. Tumors were mainly located in renal medulla with grey and firm cut face and the presence of focal hemorrhage and necrosis. Microscopically, there were predominant tubular or tubular-papillary structures with associated focal sarcomatoid areas, desmoplastic stromal reaction and lymphoplasmacytic cells infiltration. Tumor cells had marked cytological atypia with high grade nuclei, conspicuous nucleolus and numerous mitoses. Immunohistochemically, tumor cells were strongly positive for CK19, E-cadherin, vimentin, HCK, CK7 and PAX8. The main treatment was radical nephrectomy in the patients. Seven cases died of CDC with median survival of 10 months. CDC is a rare, highly aggressive malignancy of kidney with poor prognosis. Definitive diagnosis should be made by histology and immunohistochemistry. Differential diagnoses include papillary renal cell carcinoma(type â…¡), renal medullary carcinoma, infiltrating high grade urothelial carcinoma, renal pelvis adenocarcinoma and metastatic adenocarcinomas.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/patologia
Neoplasias Renais/patologia
Túbulos Renais Coletores/patologia
[Mh] Termos MeSH secundário: Caderinas/análise
Carcinoma de Células Renais/química
Carcinoma de Células de Transição/patologia
Nucléolo Celular
Núcleo Celular
Diagnóstico Diferencial
Seres Humanos
Imuno-Histoquímica
Neoplasias Renais/química
Túbulos Renais Coletores/química
Necrose/patologia
Vimentina/análise
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CDH1 protein, human); 0 (Cadherins); 0 (Vimentin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-5807.2018.02.009


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[PMID]:28452170
[Au] Autor:White V; Marco DJT; Bolton D; Davis ID; Jefford M; Hill D; Prince HM; Millar JL; Winship IM; Coory M; Giles GG
[Ad] Endereço:Cancer Council Victoria, Melbourne, Vic., Australia.
[Ti] Título:Trends in the surgical management of stage 1 renal cell carcinoma: findings from a population-based study.
[So] Source:BJU Int;120 Suppl 3:6-14, 2017 11.
[Is] ISSN:1464-410X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To determine whether the use of nephron-sparing surgery (NSS) for treatment of stage 1 renal cell carcinoma (RCC) changed between 2009 and the end of 2013 in Australia. PATIENTS AND METHODS: All adult cases of RCC diagnosed in 2009, 2012 and 2013 were identified through the population-based Victorian Cancer Registry. For each identified patient, trained data-abstractors attended treating hospitals or clinician rooms to extract tumour and treatment data through medical record review. Multivariable logistic regression analyses were carried out to examine the significance of change in use of NSS over time, after adjusting for potential confounders. RESULTS: A total of 1 836 patients with RCC were identified. Of these, the proportion of cases with stage 1 tumours was 64% in 2009, 66% in 2012 and 69% in 2013. For T1a tumours, the proportion of patients residing in metropolitan areas receiving NSS increased from 43% in 2009 to 58% in 2012 (P < 0.05), and 69% in 2013 (P < 0.05). For patients residing in non-metropolitan areas, the proportion receiving NSS increased from 27% in 2009 to 49% in 2012, and 61% in 2013 (P < 0.01). Univariable logistic regression showed patients with moderate (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.35-0.94) or severe comorbidities (OR 0.58, 95% CI 0.33-0.99), residing in non-metropolitan areas (OR 0.65, 95% CI 0.47-0.90), were less likely to be treated by NSS, while those attending high-volume hospitals (≥30 cases/year: OR 1.79, 95% CI 1.21-2.65) and those with higher socio-economic status (OR 1.45, 95% CI 1.02-2.07) were more likely to be treated by NSS. In multivariable analyses, patients with T1a tumours in 2012 (OR 2.00, 95% CI 1.34-2.97) and 2013 (OR 3.15, 95% CI 2.13-4.68) were more likely to be treated by NSS than those in 2009. For T1b tumours, use of NSS increased from 8% in 2009 to 20% in 2013 (P < 0.05). CONCLUSION: This population-based study of the management of T1 renal tumours in Australia found that the use of NSS increased over the period 2009 to 2013. Between 2009 and 2013 clinical practice for the treatment of small renal tumours in Australia has increasingly conformed to international guidelines.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/epidemiologia
Carcinoma de Células Renais/cirurgia
Neoplasias Renais/epidemiologia
Neoplasias Renais/cirurgia
Nefrectomia/estatística & dados numéricos
Tratamentos com Preservação do Órgão/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Austrália/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Nefrectomia/tendências
Tratamentos com Preservação do Órgão/tendências
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/bju.13889


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[PMID]:27771126
[Au] Autor:Davis ID; Xie W; Pezaro C; Donskov F; Wells JC; Agarwal N; Srinivas S; Yuasa T; Beuselinck B; Wood LA; Ernst DS; Kanesvaran R; Knox JJ; Pantuck A; Saleem S; Alva A; Rini BI; Lee JL; Choueiri TK; Heng DYC
[Ad] Endereço:Monash University and Eastern Health, Box Hill. Victoria, Australia. Electronic address: ian.davis@monash.edu.
[Ti] Título:Efficacy of Second-line Targeted Therapy for Renal Cell Carcinoma According to Change from Baseline in International Metastatic Renal Cell Carcinoma Database Consortium Prognostic Category.
[So] Source:Eur Urol;71(6):970-978, 2017 Jun.
[Is] ISSN:1873-7560
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We hypothesized that changes in International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic category at start of second-line therapy (2L) for metastatic renal cell carcinoma (mRCC) might predict response. OBJECTIVE: To assess outcomes of 2L according to type of therapy and change in IMDC prognostic category. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective review of the IMDC database for mRCC patients who received first-line (1L) VEGF inhibitors (VEGFi) and then 2L with VEGFi or mTOR inhibitors (mTORi). IMDC prognostic categories were defined before each line of therapy (favorable, F; intermediate, I; poor, P). Data were analyzed for 1516 patients, of whom 89% had clear cell histology. INTERVENTION: All included patients received targeted therapy for mRCC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS), time to treatment failure, and response to 2L were analyzed using Cox or logistic regression. RESULTS AND LIMITATIONS: At start of 2L, 60% of patients remained in the same prognostic category; 9.0% improved (3% I → F; 6% P → I); 31% deteriorated (15% F → I or P; 16% I → P). Patients with the same or better IMDC prognostic category had a longer time to treatment failure if they remained on VEGFi compared to those who switched to mTORi (adjusted hazard ratio [AHR] ranging from 0.33 to 0.78, adjusted p<0.05). Patients who deteriorated from F to I appeared more likely to benefit from switching to mTORi (median OS 16.5 mo, 95% confidence interval [CI] 12.0-19.0 for VEGFi; 20.2 mo, 95% CI 14.3-26.1 for mTORi; AHR 1.53, 95% CI 1.04-2.24; adjusted p=0.03). CONCLUSIONS: Changes in IMDC prognostic category predict the subsequent clinical course for patients with mRCC and provide a rational basis for selection of subsequent therapy. PATIENT SUMMARY: The pattern of treatment failure might help to predict what the next treatment should be for patients with metastatic renal cell carcinoma.
[Mh] Termos MeSH primário: Inibidores da Angiogênese/uso terapêutico
Carcinoma de Células Renais/tratamento farmacológico
Neoplasias Renais/tratamento farmacológico
Terapia de Alvo Molecular
Inibidores de Proteínas Quinases/uso terapêutico
[Mh] Termos MeSH secundário: Inibidores da Angiogênese/efeitos adversos
Carcinoma de Células Renais/enzimologia
Carcinoma de Células Renais/secundário
Bases de Dados Factuais
Progressão da Doença
Intervalo Livre de Doença
Substituição de Medicamentos
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Renais/enzimologia
Neoplasias Renais/patologia
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Modelos de Riscos Proporcionais
Inibidores de Proteínas Quinases/efeitos adversos
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo
Estudos Retrospectivos
Transdução de Sinais/efeitos dos fármacos
Serina-Treonina Quinases TOR/antagonistas & inibidores
Serina-Treonina Quinases TOR/metabolismo
Fatores de Tempo
Resultado do Tratamento
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Fator A de Crescimento do Endotélio Vascular/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Protein Kinase Inhibitors); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); EC 2.7.1.1 (MTOR protein, human); EC 2.7.1.1 (TOR Serine-Threonine Kinases); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29198818
[Au] Autor:Kim HJ; Park BK; Chung IS
[Ad] Endereço:Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
[Ti] Título:Comparison of General Anesthesia and Conscious Sedation During Computed Tomography-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma.
[So] Source:Can Assoc Radiol J;69(1):24-29, 2018 Feb.
[Is] ISSN:1488-2361
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Percutaneous radiofrequency ablation is so painful that this treatment requires pain control such as conscious sedation or general anesthesia. It is still unclear which type of anesthesia is better for treatment outcomes of renal cell carcinoma. This study aimed to compare general anesthesia and conscious sedation in treating patients with renal cell carcinoma with radiofrequency ablation. METHODS: Between 2010 and 2015, 51 patients with biopsy-proven renal cell carcinomas (<4 cm) were treated with computed tomography-guided radiofrequency ablation. General anesthesia was performed in 41 and conscious sedation was performed in 10 patients. Tumour size, local tumour progression, metastasis, major complication, effective dose, glomerular filtration rate difference, and recurrence-free survival rate were compared between these groups. RESULTS: The mean tumour size was 2.1 cm in both groups (P = .673). Local tumour progression occurred in 0% (0 of 41) of the general anesthesia group, but in 40% (4 of 10) of the conscious sedation group (P = .001). Metastases in these groups occurred in 2.4% (1 of 41) of the general anesthesia group and 20% (2 of 10) of the conscious sedation group (P = .094). No major complications developed in either group after the first radiofrequency ablation session. The mean effective doses in these groups were 21.7 mSv and 21.2 mSv, respectively (P = .868). The mean glomerular filtration rate differences in the general anesthesia and conscious sedation groups were -13.5 mL/min/1.73 m and -19.1 mL/min/1.73 m , respectively (P = .575). Three-year recurrence-free survival rates in these groups were 97.6% and 60.0%, respectively (P = .001). CONCLUSIONS: General anesthesia may provide better intermediate outcomes than conscious sedation in treating small renal cell carcinomas with radiofrequency ablation.
[Mh] Termos MeSH primário: Anestesia Geral/métodos
Carcinoma de Células Renais/cirurgia
Ablação por Cateter/métodos
Sedação Consciente/métodos
Neoplasias Renais/cirurgia
Manejo da Dor/métodos
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma de Células Renais/diagnóstico por imagem
Feminino
Seres Humanos
Neoplasias Renais/diagnóstico por imagem
Masculino
Meia-Idade
Radiografia Intervencionista/métodos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE


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[PMID]:28742884
[Au] Autor:Borzym-Kluczyk M; Radziejewska I; Cechowska-Pasko M; Darewicz B
[Ad] Endereço:Department of Pharmaceutical Biochemistry, Medical University of Bialystok, Bialystok, Poland.
[Ti] Título:Reduced expression of E-cadherin and increased sialylation level in clear cell renal cell carcinoma.
[So] Source:Acta Biochim Pol;64(3):465-470, 2017.
[Is] ISSN:1734-154X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Cancer cells are characterized by an aberrant increase in protein N-glycosylation and by disruption of E-cadherin-mediated adherens junctions. However, the relationship between alterations in N-glycosylation process and loss of E-cadherin adhesion in cancer remains unclear. The mechanisms of altered expression of adhesive glycoproteins in cancer cells have not been fully elucidated. Thus, the aim of this study was to examine the expression of E-cadherin and sialyl Lewis / , NeuAcα2-3Gal, NeuAcα2-6Gal/GalNAc structures in the normal renal tissue and intermediate and cancerous tissues from patients with clear cell RCC. Moreover, we attempted to correlate the E-cadherin expression with some specific sugar residues of renal cancer tissue glycoproteins. The expression of E-cadherin was analysed using ELISA test and immunoblotting. Oligosaccharide structures and sialylation level were detected with ELISA test using specific biotinylated lectins or antibodies. A significant decrease of E-cadherin expression as well as a significant increase in sialylated oligosaccharides level in intermediate zone and renal cancer tissue in comparison to normal renal tissue are reported. Significant decrease in expression of cadherins and increase in sialylation of oligosaccharide structures in renal cancer tissue in comparison to normal renal tissue, and in renal cancer tissue in comparison to intermediate zone of renal tissue, are important for the future research concerning detection and quantification of cadherins and sialylated oligosaccharide structures in urine and cells of urinary sediment as possible non-invasive marker of early RCC.
[Mh] Termos MeSH primário: Caderinas/metabolismo
Carcinoma de Células Renais/metabolismo
Neoplasias Renais/metabolismo
[Mh] Termos MeSH secundário: Acetilglucosamina/metabolismo
Idoso
Carcinoma de Células Renais/patologia
Feminino
Glicoconjugados/metabolismo
Glicoproteínas/metabolismo
Seres Humanos
Rim/metabolismo
Neoplasias Renais/patologia
Antígeno Lewis X/metabolismo
Masculino
Meia-Idade
Valores de Referência
Ácidos Siálicos/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CDH1 protein, human); 0 (Cadherins); 0 (Glycoconjugates); 0 (Glycoproteins); 0 (Lewis X Antigen); 0 (Sialic Acids); V956696549 (Acetylglucosamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.18388/abp.2015_1215


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[PMID]:28464919
[Au] Autor:Toth C; Funke S; Nitsche V; Liverts A; Zlachevska V; Gasis M; Wiek C; Hanenberg H; Mahotka C; Schirmacher P; Heikaus S
[Ad] Endereço:Institute of Pathology, Heinrich Heine University Hospital, Medical Faculty, Moorenstrasse 5, 40225, Düsseldorf, Germany. csaba.toth@med.uni-heidelberg.de.
[Ti] Título:The role of apoptosis repressor with a CARD domain (ARC) in the therapeutic resistance of renal cell carcinoma (RCC): the crucial role of ARC in the inhibition of extrinsic and intrinsic apoptotic signalling.
[So] Source:Cell Commun Signal;15(1):16, 2017 May 02.
[Is] ISSN:1478-811X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Renal cell carcinomas (RCCs) display broad resistance against conventional radio- and chemotherapies, which is due at least in part to impairments in both extrinsic and intrinsic apoptotic pathways. One important anti-apoptotic factor that is strongly overexpressed in RCCs and known to inhibit both apoptotic pathways is ARC (apoptosis repressor with a CARD domain). METHODS: Expression and subcellular distribution of ARC in RCC tissue samples and RCC cell lines were determined by immunohistochemistry and fluorescent immunohistochemistry, respectively. Extrinsic and intrinsic apoptosis signalling were induced by TRAIL (TNF-related apoptosis-inducing ligand), ABT-263 or topotecan. ARC knock-down was performed in clearCa-12 cells using lentiviral transduction of pGIPZ. shRNAmir constructs. Extrinsic respectively intrinsic apoptosis were induced by TRAIL (TNF-related apoptosis-inducing ligand), ABT263 or topotecan. Potential synergistic effects were tested by pre-treatment with topotecan and subsequent treatment with ABT263. Activation of different caspases and mitochondrial depolarisation (JC-1 staining) were analysed by flow cytometry. Protein expression of Bcl-2 family members and ARC in RCC cell lines was measured by Western blotting. Statistical analysis was performed by Student's t-test. RESULTS: Regarding the extrinsic pathway, ARC knockdown strongly enhanced TRAIL-induced apoptosis by increasing the activation level of caspase-8. Regarding the intrinsic pathway, ARC, which was only weakly expressed in the nuclei of RCCs in vivo, exerted its anti-apoptotic effect by impairing mitochondrial activation rather than inhibiting p53. Topotecan- and ABT-263-induced apoptosis was strongly enhanced following ARC knockdown in RCC cell lines. In addition, topotecan pre-treatment enhanced ABT-263-induced apoptosis and this effect was amplified in ARC-knockdown cells. CONCLUSION: Taken together, our results are the first to demonstrate the importance of ARC protein in the inhibition of both the extrinsic and intrinsic pathways of apoptosis in RCCs. In this context, ARC cooperates with anti-apoptotic Bcl-2 family members to exert its strong anti-apoptotic effects and is therefore an important factor not only in the therapeutic resistance but also in future therapy strategies (i.e., Bcl-2 inhibitors) in RCC. In sum, targeting of ARC may enhance the therapeutic response in combination therapy protocols.
[Mh] Termos MeSH primário: Proteínas Reguladoras de Apoptose/metabolismo
Apoptose/efeitos dos fármacos
Carcinoma de Células Renais/patologia
Resistência a Medicamentos Antineoplásicos
Neoplasias Renais/patologia
Proteínas Musculares/metabolismo
[Mh] Termos MeSH secundário: Transporte Ativo do Núcleo Celular/efeitos dos fármacos
Compostos de Anilina/farmacologia
Proteínas Reguladoras de Apoptose/deficiência
Proteínas Reguladoras de Apoptose/genética
Linhagem Celular Tumoral
Núcleo Celular/efeitos dos fármacos
Núcleo Celular/metabolismo
Citoplasma/efeitos dos fármacos
Citoplasma/metabolismo
Resistência a Medicamentos Antineoplásicos/efeitos dos fármacos
Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos
Técnicas de Silenciamento de Genes
Seres Humanos
Mitocôndrias/efeitos dos fármacos
Mitocôndrias/patologia
Terapia de Alvo Molecular
Proteínas Musculares/deficiência
Proteínas Musculares/genética
Proteínas Proto-Oncogênicas c-bcl-2/metabolismo
Sulfonamidas/farmacologia
Topotecan/farmacologia
Proteína Supressora de Tumor p53/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aniline Compounds); 0 (Apoptosis Regulatory Proteins); 0 (Muscle Proteins); 0 (NOL3 protein, human); 0 (Proto-Oncogene Proteins c-bcl-2); 0 (Sulfonamides); 0 (Tumor Suppressor Protein p53); 7M7YKX2N15 (Topotecan); XKJ5VVK2WD (navitoclax)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12964-017-0170-5


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[PMID]:28463153
[Au] Autor:Bang A; Wilhite TJ; Pike LRG; Cagney DN; Aizer AA; Taylor A; Spektor A; Krishnan M; Ott PA; Balboni TA; Hodi FS; Schoenfeld JD
[Ad] Endereço:Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Radiation Oncology, University of Ottawa, Ottawa, Ontario, Canada.
[Ti] Título:Multicenter Evaluation of the Tolerability of Combined Treatment With PD-1 and CTLA-4 Immune Checkpoint Inhibitors and Palliative Radiation Therapy.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):344-351, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To analyze immune-related adverse events (ir-AEs) in patients treated with radiation and immune checkpoint blockade. METHODS AND MATERIALS: We retrospectively reviewed records from patients with metastatic non-small cell lung cancer, melanoma, or renal cell cancer who received at least 1 cycle of a CTLA-4 or PD-1 inhibitor and radiation. Immune-related adverse events, defined using Common Terminology Criteria for Adverse Events version 4.0, were tabulated in relation to treatment variables, and associations with sequencing and timing were assessed. RESULTS: We identified 133 patients, of whom 28 received a CTLA-4 inhibitor alone, 88 received a PD-1 inhibitor alone, and 17 received both classes of inhibitors either sequentially (n=13) or concurrently (n=4). Fifty-six patients received radiation within 14 days of an immune checkpoint inhibitor. Forty-six patients experienced at least 1 ir-AE (34.6%). Patients receiving both CTLA-4 and PD-1 inhibitors experienced more any-grade ir-AEs as compared with either individually (71% vs 29%, P=.0008). Any-grade ir-AEs occurred in 39% of patients in whom radiation was administered within 14 days of immunotherapy, compared with 23% of other patients (P=.06) and more often in patients who received higher equivalent dose in 2-Gy fractions (EQD2) EQD2 (P=.01). However, most toxicities were mild. There were no associations between site irradiated and specific ir-AEs. CONCLUSIONS: Our data suggest the combination of focal palliative radiation and CTLA-4 and/or PD-1 inhibitors is well tolerated, with manageable ir-AEs that did not seem to be associated with the particular site irradiated. Although conclusions are limited by the heterogeneity of patients and treatments, and future confirmatory studies are needed, this information can help guide clinical practice for patients receiving immune checkpoint therapy who require palliative radiation therapy.
[Mh] Termos MeSH primário: Antígeno CTLA-4/antagonistas & inibidores
Carcinoma Pulmonar de Células não Pequenas/terapia
Carcinoma de Células Renais/terapia
Pontos de Checagem do Ciclo Celular/imunologia
Imunoterapia/efeitos adversos
Neoplasias Renais/terapia
Neoplasias Pulmonares/terapia
Melanoma/terapia
Receptor de Morte Celular Programada 1/antagonistas & inibidores
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma Pulmonar de Células não Pequenas/secundário
Carcinoma de Células Renais/secundário
Pontos de Checagem do Ciclo Celular/efeitos dos fármacos
Colite/etiologia
Terapia Combinada/efeitos adversos
Terapia Combinada/métodos
Dermatite/etiologia
Feminino
Seres Humanos
Imunoterapia/métodos
Neoplasias Renais/patologia
Neoplasias Pulmonares/patologia
Masculino
Melanoma/secundário
Meia-Idade
Cuidados Paliativos/métodos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (CTLA-4 Antigen); 0 (CTLA4 protein, human); 0 (PDCD1 protein, human); 0 (Programmed Cell Death 1 Receptor)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:27776978
[Au] Autor:Wang Z; Wang G; Xia Q; Shang Z; Yu X; Wang M; Jin X
[Ad] Endereço:Minimally Invasive Urology Center, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
[Ti] Título:Partial nephrectomy vs. radical nephrectomy for renal tumors: A meta-analysis of renal function and cardiovascular outcomes.
[So] Source:Urol Oncol;34(12):533.e11-533.e19, 2016 12.
[Is] ISSN:1873-2496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The widespread use of partial nephrectomy (PN) has led to the preservation of functional renal parenchyma. However, the benefits of PN on renal function and cardiovascular outcomes remain controversial. Thus, a meta-analysis was performed to reconcile the conflicting results. MATERIALS AND METHODS: PubMed, Embase, and the Cochrane Library were searched from inception to August 2015, and databases with all relevant comparative studies were included. The Mantel-Haenszel method with random-effects models was used to determine the pooled hazard ratios (HRs) for each outcome. RESULTS: In total, 26 studies were pooled for new-onset chronic kidney disease, and 6 studies were pooled for cardiovascular outcomes. According to the pooled estimates, PN correlated with a 73% risk reduction of new-onset chronic kidney disease in all included patients (HR = 0.27, P<0.0001) and a 65% risk reduction in patients with tumors>4cm (HR = 0.35, P<0.0001) compared with radical nephrectomy. There were no significant differences between groups regarding postsurgery cardiovascular events (HR = 0.86, P = 0.238) and cardiovascular death (HR = 0.79, P = 0.196). Despite inherent selection biases, the pooled estimates were robust in sensitivity and subgroup analyses. CONCLUSIONS: Our findings suggest that PN lowers the postoperative risk of new-onset chronic kidney disease. Nevertheless, the protection of renal function by PN did not reduce the risk of cardiovascular outcomes. However, this result remains controversial, and additional large-scale evaluations are warranted.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/cirurgia
Rim/fisiopatologia
Nefrectomia/métodos
[Mh] Termos MeSH secundário: Carcinoma de Células Renais/fisiopatologia
Estudos de Casos e Controles
Estudos de Coortes
Seguimentos
Cardiopatias/epidemiologia
Cardiopatias/prevenção & controle
Seres Humanos
Neoplasias Renais/fisiopatologia
Insuficiência Renal Crônica/epidemiologia
Insuficiência Renal Crônica/prevenção & controle
Estudos Retrospectivos
Comportamento de Redução do Risco
Viés de Seleção
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:27770346
[Au] Autor:Lee SR; Gemenetzis G; Cooper M; Javed AA; Cameron JL; Wolfgang CL; Eckhauser FE; He J; Weiss MJ
[Ad] Endereço:Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
[Ti] Título:Long-Term Outcomes of 98 Surgically Resected Metastatic Tumors in the Pancreas.
[So] Source:Ann Surg Oncol;24(3):801-807, 2017 Mar.
[Is] ISSN:1534-4681
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The goal of this study was to assess the outcomes and characteristics of patients who underwent pancreatectomy for metastatic disease to the pancreas. METHODS: Patients who underwent surgical resection of metastatic disease to the pancreas from 1988 to 2016 were identified using a prospectively maintained database. Data on clinicopathological features and outcomes of these patients were analyzed. Cox proportional hazard models were employed to identify patient-specific risk factors that influence survival. RESULTS: Ninety-seven patients underwent 98 pancreatic metastasectomies from July 1988 through March 2016 for metastatic disease from 13 different primary cancers. Pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy were performed in 49 (50 %), 37 (38 %), and 12 (12 %) patients, respectively. Postoperative complications occurred in 55 (56 %) patients, while 3 (3 %) perioperative deaths occurred. Median follow-up was 2.0 years, with a median survival of 3.2 years. Multivariate analysis revealed that older patients [hazard ratio (HR) 1.04/year; p = 0.006], non-renal cell carcinomas (HR 5.07; p < 0.001), vascular invasion (HR 3.53; p < 0.001), and positive resection margins (HR 2.62; p = 0.008) were independently associated with an increased risk of mortality. CONCLUSIONS: Pancreatic metastasectomy is safe and feasible in well-selected patients and is associated with acceptable long-term survival.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/patologia
Metastasectomia
Neoplasias Pancreáticas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Vasos Sanguíneos/patologia
Carcinoma de Células Renais/secundário
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Invasividade Neoplásica
Neoplasia Residual
Pancreatectomia
Neoplasias Pancreáticas/patologia
Neoplasias Pancreáticas/secundário
Pancreaticoduodenectomia
Complicações Pós-Operatórias/etiologia
Fatores de Risco
Taxa de Sobrevida
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1245/s10434-016-5619-z



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