Clear Cell Renal Cell Carcinoma: A Test Bench for Investigating Tumor Complexity.

Clear cell renal cell carcinoma (CCRCC), by far the most common renal cancer subtype, is an aggressive tumor variant, serving in recent years as a prolific test bench in cancer research [...].

Benign Mesothelial Proliferations of the Tunica Vaginalis Testis.

The correct diagnosis of mesothelial proliferations is a classic problem for pathologists, and one which has important clinical implications. A significant number of such cases appear associated with recurrent hydrocele, as an irritative/reactive response to this condition. The morphological spectrum of mesothelial lesions in this topography is broad, and a set of benign conditions may appear, sometimes with florid gross features and cytologic pseudo-atypia. Here, we present two different examples in which malignancy was initially considered in the differential diagnosis.

Advances in Urological Cancer in 2022, from Basic Approaches to Clinical Management.

This Special Issue includes 12 articles and 3 reviews dealing with several basic and clinical aspects of prostate, renal, and urinary tract cancer published during 2022 in Cancers, and intends to serve as a multidisciplinary chance to share the last advances in urological neoplasms [...].

Towards Personalized Sampling in Clear Cell Renal Cell Carcinomas.

Intratumor heterogeneity (ITH) is a constant evolutionary event in all malignant tumors, and clear cell renal cell carcinoma (CCRCC) is a paradigmatic example. ITH is responsible for most therapeutic failures in the era of precision oncology, so its precise detection remains a must in modern medicine. Unfortunately, classic sampling protocols do not resolve the problem as expected and several strategies have been being implemented in recent years to improve such detection. Basically, multisite tumor sampling (MSTS) and the homogenization of the residual tumor tissue are on display. A next step of the MSTS strategy considering the recently discovered patterns of ITH regionalization is presented here, the so-called personalized MSTS (pMSTS). This modification consists of paying more attention to sample the tumor periphery since it is this area with maximum levels of ITH.

Digital Tools for Translucence Evaluation of Prosthodontic Materials: Application of Kubelka-Munk Theory.

Translucency is one of the most important parameters to be considered by digital systems when predicting the matching appearance and hence the quality of prosthodontic restoration work. Our objective has been to improve the effectiveness of the algorithmic decision systems employed by these devices by (a) determining whether Kubelka-Munk theory can be used as an algorithm for predicting restoration suitability, and (b) evaluating the correlation between the visual evaluation of prosthodontic materials and the predicted translucency based on the use of the ΔE*, OP, CR, and K/S algorithms. In this regard, three zirconia systems and one lithium disilicate have been spectrophotometrically and visually characterized. Based on the results of this study, it has been proven that zirconia systems and lithium disilicate systems exhibit different optical behaviors. The psychophysical experience suggests that none of the existing mathematical methods can adequately estimate translucency, spectrophotometric, and colorimetric techniques, and that which is perceived by an experienced observer. However, translucency evaluation through the K/S algorithmic decision system should not be disregarded. New methods to measure translucency should be developed to improve digital systems for prosthodontic applications.

Clear Cell Renal Cell Carcinomas with Aggressive Behavior Display Low Intratumor Heterogeneity at the Histological Level.

PURPOSE OF REVIEW: Intratumor heterogeneity (ITH) is an inherent characteristic of most tumors and its detection remains a key task for pathologists. However, the clinical significance of the degree of development of this feature is still poorly understood. RECENT FINDINGS: A series of 28 clear cell renal cell carcinomas (CCRCC) have been exhaustively analyzed with two different sampling protocols [multisite tumor sampling (MSTS) and total sampling] to evaluate to what point the level (low vs. high) of histological ITH detected in routine practice influences tumor behavior and patients' survival. All CCRCC (n = 14) pursuing an aggressive clinical course presented low levels of ITH. A significant worse survival was detected in CCRCC with low ITH (p < 0.001). The simple quantification of the level of ITH using extensive sampling protocol may be of help in predicting tumor evolution, since all CCRCC with aggressive behavior demonstrated low levels of histological ITH.

Urological Cancer Panorama in the Second Year of the COVID-19 Pandemic.

A total of 22 contributions conforms this Special Issue that covers a wide spectrum of contemporary issues in urological cancer, a group of neoplasms with high incidence, prevalence, and mortality rates, especially in the male population of Western countries [...].

Precision sampling fuels precision oncology: an evolutionary perspective.

Intratumor heterogeneity (ITH) develops in malignant tumors. Precision sampling that captures this tumor variability is essential for the implementation of precision oncology. We highlight the necessity to update current sampling protocols and implement a strategy to ensure ITH detection and characterization. A cost-effective strategy for such sampling has been modeled in clear cell renal cell carcinoma (CCRCC).

The Impact of Tumor Eco-Evolution in Renal Cell Carcinoma Sampling.

Malignant tumors behave dynamically as cell communities governed by ecological principles. Massive sequencing tools are unveiling the true dimension of the heterogeneity of these communities along their evolution in most human neoplasms, clear cell renal cell carcinomas (CCRCC) included. Although initially thought to be purely stochastic processes, very recent genomic analyses have shown that temporal tumor evolution in CCRCC may follow some deterministic pathways that give rise to different clones and sub-clones randomly spatially distributed across the tumor. This fact makes each case unique, unrepeatable and unpredictable. Precise and complete molecular information is crucial for patients with cancer since it may help in establishing a personalized therapy. Intratumor heterogeneity (ITH) detection relies on the correctness of tumor sampling and this is part of the pathologist's daily work. International protocols for tumor sampling are insufficient today. They were conceived decades ago, when ITH was not an issue, and have remained unchanged until now. Noteworthy, an alternative and more efficient sampling method for detecting ITH has been developed recently. This new method, called multisite tumor sampling (MSTS), is specifically addressed to large tumors that are impossible to be totally sampled, and represent an opportunity to improve ITH detection without extra costs.