Prognostic value of vascular endothelial growth factor (VEGF), VEGF receptor 2, platelet-derived growth factor-ß (PDGF-ß), and PDGF-ß receptor expression in papillary renal cell carcinoma.

The prognostic value of the expression of vascular endothelial growth factor (VEGF), VEGF receptor 2 (VEGFR2), platelet-derived growth factor (PDGF)-ß, and PDGF receptor (PDGFR)-ß in papillary renal cell carcinoma (pRCC) is unknown. A total of 145 patients, who were confirmed to have pRCC, were analyzed. Expression levels of molecular markers were assessed via immunohistochemistry. The median follow-up period for all patients was 52.0 (interquartile range, 34.5-90.5) months. Among the cohort of 145 patients, high VEGF expression was observed in 100 (69.0%) patients, whereas high expression of VEGFR2, PDGF-ß, and PDGFR-ß was observed in 64 (44.1%), 42 (29.0%), and 30 (20.7%) patients, respectively. Only patients with high VEGFR2 expression exhibited improved 10-year recurrence-free survival (85.3% versus 58.1%; P=.005) and cancer-specific survival (86.4% versus 70.1%; P=.014) rates compared with individuals who exhibited low expression. Multivariate analysis revealed that high VEGFR2 expression was an independent prognostic factor for recurrence (hazard ratio, 0.326; P=.006) and cancer-specific mortality (hazard ratio, 0.334; P=.046). During follow-up, 17 patients received targeted drug therapy. Patients with high VEGFR2 expression showed a better initial response (partial response, 40%; stable disease, 20%; progressive disease, 40%) than patients with low expression did (partial response, 0%; stable disease, 58.3%; progressive disease, 41.7%; P=.052). pRCC with high VEGFR2 expression seems to be associated with a better initial response to targeted drug therapy and a better prognostic outcome.

Outcomes of patients with ureteral obstruction who achieved stent-free state following balloon dilatation.

OBJECTIVE: The aim of this study was to assess the therapeutic role of ureteral stent removal following balloon dilatation (BD) in patients with a stent implanted for unilateral ureteral obstruction and with normal contralateral renal function. MATERIALS AND METHODS: This retrospective cohort study consisted of 37 consecutive patients with unilateral ureteral obstruction whose stents were removed after BD. All patients satisfied the following criteria: normal contralateral renal function, no evidence of malignancy, and the patient was eager to obtain a stent-free state (SFS) without invasive treatment. The relative function of the affected kidney and total renal function before and after stent removal were analyzed using renal scans and estimated glomerular filtration rate (eGFR). A successful outcome was defined as SFS without pain or febrile urinary tract infection plus maintenance of eGFR. RESULTS: The mean age of all patients was 58.2 years. The mean follow-up periods before and after stent removals were 15.7 and 23.6 months, respectively. The most common underlying cause of ureteral obstruction was pelvic or abdominal surgery (51.4%). Of the 37 patients, 32 (86.5%) achieved successful SFS at last follow-up. Overall in the 37 patients, the eGFR (from 77.1 to 69.8 ml/min/1.73 m(2); p = 0.017) and relative renal function of the affected kidney (from 35.5 to 30.2%; p = 0.002) were significantly compromised. However, the reduction in total eGFR was not significant (p = 0.075) in the successful SFS group. CONCLUSION: The removal of a stent with BD is a viable option for achieving a successful SFS in patients with unilateral ureteral obstruction.

Prognostic value of ABO blood group in patients with renal cell carcinoma: single-institution results from a large cohort.

OBJECTIVES: To evaluate the association between ABO blood group and prognosis in patients with renal cell carcinoma (RCC) undergoing surgery. MATERIALS AND METHODS: A review of the nephrectomy database of the Asan Medical Center identified 3,172 consecutive patients who underwent nephrectomy for RCC between 1997 and 2012. Patients were followed up for a median 60.2 months (interquartile range 33-102 months). Recurrence-free (RFS), cancer-specific (CSS), and overall survival (OS) were calculated by the Kaplan-Meier method and compared using the log-rank test. A Cox proportional hazards regression model was used to estimate the prognostic significance of each variable. RESULTS: Of these 3,172 patients, 915 (28.8 %), 1,057 (33.7 %), 860 (26.7 %) and 340 (10.8 %) were blood types O, A, B, and AB, respectively. ABO blood group was not associated with age, sex, operation method, American Society of Anesthesiologists physical status classification, histologic subtype, or pathological TNM stage. The 5-year OS rates in patients with blood types O, A, B, and AB were 86.0, 86.8, 86.6, and 88.6 %, respectively, and the 10-year OS rates were 78.7, 78.6, 79.1, and 76.9 %, respectively (P = 0.990). ABO blood group was not significantly associated with RFS (P = 0.921) or CSS (P = 0.808). Univariable and multivariable analyses showed that ABO blood group was not a significant prognostic factor of RFS, CSS, or OS. CONCLUSIONS: Our study found that ABO blood group is not associated with survival outcomes and is not a prognostic factor in patients who underwent surgery for RCC.

Histologic variability and diverse oncologic outcomes of prostate sarcomas.

PURPOSE: Primary prostate sarcomas are a rare type of prostate cancer that account for less than 0.1% of primary prostate malignancies. We analyzed the experience of a single institution with prostate sarcoma over 20 years. MATERIALS AND METHODS: In this case series, the medical records of 20 patients with prostate sarcoma were reviewed from June 1990 to December 2013 to identify symptoms at presentation, diagnostic procedures, metastasis presence and development, histologic subtype, French Fédération Nationale des Centres de Lutte Contre le Cancer grade, primary tumor grade and size, and treatment sequence, including surgery and preoperative and postoperative therapies. The average follow-up period was 23.6 months (range, 1.4-83.3 months). RESULTS: The average patient age was 46.3 ± 16.7 years. Most patients presented with lower urinary tract symptoms (55%). The histologic subtype was spindle cell sarcoma in five patients (25%), rhabdomyosarcoma in three patients (15%), synovial sarcoma in three patients (15%), liposarcoma in three patients (15%), stromal sarcoma in three patients (15%), and Ewing sarcoma, nerve sheath tumor, and adenocarcinoma with sarcomatoid component (5% each). For liposarcoma, two patients were alive after complete surgical resection and had a good prognosis. At last follow-up, 15 patients had died of sarcoma. The 2- and 5-year actuarial survival rates for all 20 patients were 53% and 12%, respectively (medial survival, 20 months). CONCLUSIONS: The disease-specific survival rate of prostate sarcoma is poor. However, sarcoma that is detected early shows a better result with proper management including surgical intervention with radio-chemotherapy than with no treatment. Early diagnosis and complete surgical resection offer patients the best curative chance.