Comparison of survival rates in patients with metastatic renal cell carcinoma according to treatment era including cytokine and targeted therapy.

We compared the survival rates in patients with metastatic renal cell carcinoma between the cytokine and molecular targeted therapy era. The study included 321 patients who were diagnosed with metastatic renal cell carcinoma between 1987 and 2011. The patients were divided into two groups according to when they started therapy for metastatic renal cell carcinoma: in the cytokine era (1987-2007) and in the targeted therapy era (after 2008). The beginning of the follow-up period was defined as the time of discovery of metastasis occurrence. Cytokine and targeted therapy eras included 235 and 86 patients, respectively. Seventy-five percent of the patients in the cytokine era actually received cytokine therapy. Eighty-one percent of the patients in the targeted therapy era received targeted therapy and 14% received both cytokine and targeted therapy. There were no significant differences in overall survival rates (cytokine 29 months, targeted 38 months, P = 0.1789).

Postoperative renal function after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease: a comparison with radical nephrectomy.

We assessed whether adequately functioning parenchyma is preserved in patients with pre-existing chronic kidney disease (CKD) after partial nephrectomy (PN) compared with those who underwent radical nephrectomy (RN). A total of 95 patients with pre-existing CKD who underwent curative surgery for pathological T1a-T2N0M0 renal cell carcinoma with a follow-up period of 12 months or more were the subject of the present study. Of these, 51 patients underwent RN, and 44 PN. Renal function was assessed by using the estimated glomerular filtration rate (e-GFR). We classified the subjects into two groups according to the preoperative e-GFR: preoperative e-GFR 45-59 mL/min/1.73 m(2) (68 patients); and 30-44 mL/min/1.73 m(2) (27 patients). In the former group, the probability of freedom from new onset of e-GFR <45 mL/min/1.73 m(2) stemmed from the significant difference between the PN and RN groups (P = 0.006; PN: 2 years 64%; RN: 2 years 22%). In contrast, in the latter group, the probability of freedom from new onset of e-GFR <30 mL/min/1.73 m(2) was not associated with a significant difference between PN and RN group (P = 0.80). Overall survival and the number of the patients who went on to develop end-stage renal disease requiring renal replacement therapy between PN and RN were not significantly different in each group. Death from renal cell carcinoma was not noted in either group. PN could significantly prevent development to late-stage CKD in patients with preoperative e-GFR 45-59 mL/min/1.73 m(2) compared with RN. Patients with preoperative e-GFR 30-44 mL/min/1.73 m(2) should be reviewed in a more strict study.

[Case report of rhabdoid tumor of the kidney occurring in own kidney following kidney transplantation from the living relative].

The patient was a 30-year-old man who had undergone living-donor kidney transplantation for renal failure caused by IgA nephropathy at age 29. On post-transplantation day 83, he visited our department with a chief complaint of asymptomatic hematuria. CT performed on post-transplantation day 95 revealed a tumor (size, 4 cm) in the right native kidney that had not been observed at the time of transplantation. CT performed on post-transplantation day 153 showed that the tumor had enlarged to 6 cm, while retrograde pyelogram performed on post-transplantation day 171 was negative for renal pelvic tumor. On post-transplantation day 193, radical right nephrectomy was performed. The tumor had directly invaded the diaphragm and the lower surface of the liver, and was histopathologically diagnosed as rhabdoid tumor of the kidney. As the pathological tissue was extremely malignant, hepatic posterior segmentectomy, right adrenalectomy, and lymph node dissection were further performed for metastases on post-transplantation day 200. On the 23rd day after radical right nephrectomy (post-transplantation day 216), the patient developed dyspnea. Chest CT showed pleural effusion, hemothorax in right lung and metastases in both lungs. The patient's general status gradually worsened thereafter, and he died on the 53rd day after radical right nephrectomy (post-transplantation day 246). Rhabdoid tumor of the kidney is a rare renal tumor that affects children, and only four adult cases have been reported to date. We report our experience with this rare case.