PURPOSE: Although angiogenesis has been implicated in the promotion of renal cyst growth in autosomal dominant polycystic kidney disease, no studies have investigated the role of angiogenesis in the growth of simple renal cysts. The aim of current study was to investigate the effect of chemotherapy with the antivascular endothelial growth factor antibody bevacizumab on renal cyst development and growth in cancer patients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 136 patients with a variety of cancers that were treated with bevacizumab-based chemotherapy for metastatic disease. The presence of and changes in renal cysts were evaluated by retrospective analysis of computed tomography scans performed for assessment of tumor response to bevacizumab-based therapy. RESULTS: The median age of the patients was 64 years. Renal cysts were identified in 66 patients, in whom 33 (50%) had a single cyst and the rest had 2 or more cysts. The average dose of bevacizumab was 2.68 mg/kg per week. Median duration of treatment was 33 weeks. Average cyst size was 1.9±2.4 cm at the beginning of the study and the majority of the cysts (54 patients, 84%) did not change in size or shape during bevacizumab treatment. No patients were identified with new cysts. Cyst size changed in 10 patients (16%): an increase of 15% to 40% from the baseline size in 5 patients and a decrease in size of 10% to 70% in another 5 patients. The duration of bevacizumab therapy was significantly longer in the subgroup of patients with diminished or increased cyst size than in the patients with stable cyst size: 62 weeks versus 29 weeks, respectively (p=0.0002). CONCLUSIONS: Our data demonstrated that simple renal cysts were stable in size and number in the vast majority of cancer patients treated with bevacizumab.
Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/administration & dosage/*therapeutic use ; Bevacizumab/administration & dosage/*therapeutic use ; Cysts/complications/*drug therapy/pathology ; Disease Progression ; Dose-Response Relationship, Drug ; Drug Evaluation/methods ; Female ; Humans ; Kidney Diseases/complications/*drug therapy/pathology ; Male ; Middle Aged ; Neoplasms/complications/drug therapy ; Retrospective Studies ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors

Abdominal Neoplasms ; complications ; secondary ; therapy ; Acute Lung Injury ; diagnostic imaging ; etiology ; Anemia ; complications ; therapy ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child, Preschool ; Etoposide ; administration & dosage ; Fluoroscopy ; Humans ; Ifosfamide ; administration & dosage ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; complications ; secondary ; therapy ; Male ; Postoperative Complications ; diagnostic imaging ; etiology ; Prosthesis Implantation ; Radiography, Thoracic ; Radiotherapy ; Respiratory Distress Syndrome, Adult ; diagnostic imaging ; etiology ; Transfusion Reaction ; Vascular Access Devices

Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.
Carcinoma, Hepatocellular/complications/*diagnosis/therapy ; Carcinoma, Renal Cell/complications/*diagnosis/therapy ; Catheter Ablation ; Humans ; Kidney Neoplasms/complications/*diagnosis/therapy ; Liver Cirrhosis/complications/*diagnosis ; Liver Neoplasms/complications/*diagnosis/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

No abstract available.
Carcinoma, Renal Cell/*complications/pathology/surgery ; Danazol/therapeutic use ; Humans ; Kidney Neoplasms/*complications/pathology/surgery ; Male ; Middle Aged ; Nephrectomy ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic/blood/drug therapy/*etiology

BACKGROUND/AIMS: Sunitinib is an oral multitargeted tyrosine kinase inhibitor used mainly for the treatment of metastatic renal cell carcinoma. The renal adverse effects (RAEs) of sunitinib have not been investigated. The aim of this study was to determine the incidence and risk factors of RAEs (proteinuria [PU] and renal insufficiency [RI]) and to investigate the relationship between PU and antitumor efficacy. METHODS: We performed a retrospective review of medical records of patients who had received sunitinib for more than 3 months. RESULTS: One hundred and fifty-five patients (mean age, 58.7 +/- 12.6 years) were enrolled, and the mean baseline creatinine level was 1.24 mg/dL. PU developed in 15 of 111 patients, and preexisting PU was aggravated in six of 111 patients. Only one patient developed typical nephrotic syndrome. Following discontinuation of sunitinib, PU was improved in 12 of 17 patients but persisted in five of 17 patients. RI occurred in 12 of 155 patients, and the maximum creatinine level was 3.31 mg/dL. RI improved in two of 12 patients but persisted in 10 of 12 patients. Risk factors for PU were hypertension, dyslipidemia, and chronic kidney disease. Older age was a risk factor for RI. The median progression-free survival was significantly better for patients who showed PU. CONCLUSIONS: The incidence of RAEs associated with sunitinib was lower than those of previous reports. The severity of RAEs was mild to moderate, and partially reversible after cessation of sunitinib. We suggest that blood pressure, urinalysis, and renal function in patients receiving sunitinib should be monitored closely.
Aged ; Antineoplastic Agents/*adverse effects ; Carcinoma, Renal Cell/complications/drug therapy/mortality ; Female ; Humans ; Incidence ; Indoles/*adverse effects ; Kidney Neoplasms/complications/drug therapy/mortality ; Male ; Middle Aged ; Proteinuria/*chemically induced/epidemiology ; Pyrroles/*adverse effects ; Renal Insufficiency/*chemically induced/epidemiology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Treatment Outcome

Antineoplastic Agents ; adverse effects ; Child ; Child, Preschool ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Kidney Diseases ; etiology ; pathology ; therapy ; Kidney Neoplasms ; etiology ; pathology ; therapy ; Neoplasms ; complications ; therapy ; Paraneoplastic Syndromes ; etiology ; pathology ; therapy ; Radiotherapy ; adverse effects ; Risk Factors ; Tumor Lysis Syndrome ; etiology ; pathology ; therapy

BACKGROUND/AIMS: Nonselective beta-blockers (NSBBs), such as propranolol, reportedly exert a pleiotropic effect in liver cirrhosis. A previous report suggested that survival was higher in patients receiving adjusted doses of NSBBs than in ligation patients. This study investigated whether low-dose NSBB medication has beneficial effects in patients with liver cirrhosis, especially in terms of overall survival. METHODS: We retrospectively studied 273 cirrhotic patients (199 males; age 53.6+/-10.2 years, mean+/-SD) who visited our institution between March 2003 and December 2007; follow-up data were collected until June 2011. Among them, 138 patients were given a low-dose NSBB (BB group: propranolol, 20-60 mg/day), and the remaining 135 patients were not given an NSBB (NBB group). Both groups were stratified randomly according to Child-Turcotte-Pugh (CTP) classification and age. RESULTS: The causes of liver cirrhosis were alcohol (n=109, 39.9%), hepatitis B virus (n=125, 45.8%), hepatitis C virus (n=20, 7.3%), and cryptogenic (n=19, 7.0%). The CTP classes were distributed as follows: A, n=116, 42.5%; B, n=126, 46.2%; and C, n=31, 11.4%. Neither the overall survival (P=0.133) nor the hepatocellular carcinoma (HCC)-free survival (P=0.910) differed significantly between the BB and NBB groups [probability of overall survival at 4 years: 75.1% (95% CI=67.7-82.5%) and 81.2% (95% CI=74.4-88.0%), respectively; P=0.236]. In addition, the delta CTP score did not differ significantly between the two groups. CONCLUSIONS: Use of low-dose NSBB medication in patients with liver cirrhosis is not indicated in terms of overall and HCC-free survival.
Adrenergic beta-Antagonists/*therapeutic use ; Adult ; Aged ; Alcohol Drinking ; Carcinoma, Hepatocellular/complications/diagnosis ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/complications/diagnosis ; Liver Cirrhosis/complications/*drug therapy/mortality ; Liver Neoplasms/complications/diagnosis ; Male ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; Propranolol/*therapeutic use ; Retrospective Studies ; Severity of Illness Index

Angiotensin II type 1 receptor blocker (ARB), which is frequently prescribed in patients with glomerulonephritis (GN), is suggested to increase the risk of cancer. We registered 3,288 patients with renal biopsy and analyzed the relationship between the use of renin-angiotensin-aldosterone system (RAAS) blockade and the incidence of cancer or cancer mortality. After renal biopsy, cancer developed in 33 patients with an incidence rate of 1.0% (95% of CI for incidence: 0.7%-1.3%). There was no difference in the cancer incidence among the groups according to the use of angiotensin-converting enzyme inhibitors (ACEI) or ARB: 1.2% in the None (23/1960), 0.7% in the ARB-only (5/748), 0.4% in the ACEI-only (1/247), and 1.2% in the ACEI-ARB (4/333) (P = 0.487) groups. The cancer mortality was 2.1%, 0.4%, 0.0%, and 0.3% in None, ACEI-only, ARB-only, and ACEI-ARB group, respectively (P < 0.001). The risk of cancer mortality in patients with ARB was only 0.124 (0.034-0.445) compared to that of non-users of ARB by Cox's hazard proportional analysis. In conclusion, prescription of ACEI or ARB in patients with GN does not increase cancer incidence and recipients of ARB show rather lower rates of all-cause mortality and cancer mortality.
Adult ; Aged ; Angiotensin II Type 1 Receptor Blockers/*therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/*therapeutic use ; Female ; Follow-Up Studies ; Glomerulonephritis/complications/diagnosis/*drug therapy ; Humans ; Incidence ; Kidney/pathology ; Male ; Middle Aged ; Neoplasms/complications/*epidemiology/mortality ; Renin-Angiotensin System/*drug effects ; Retrospective Studies ; Risk Factors

Angiotensin II type 1 receptor blocker (ARB), which is frequently prescribed in patients with glomerulonephritis (GN), is suggested to increase the risk of cancer. We registered 3,288 patients with renal biopsy and analyzed the relationship between the use of renin-angiotensin-aldosterone system (RAAS) blockade and the incidence of cancer or cancer mortality. After renal biopsy, cancer developed in 33 patients with an incidence rate of 1.0% (95% of CI for incidence: 0.7%-1.3%). There was no difference in the cancer incidence among the groups according to the use of angiotensin-converting enzyme inhibitors (ACEI) or ARB: 1.2% in the None (23/1960), 0.7% in the ARB-only (5/748), 0.4% in the ACEI-only (1/247), and 1.2% in the ACEI-ARB (4/333) (P = 0.487) groups. The cancer mortality was 2.1%, 0.4%, 0.0%, and 0.3% in None, ACEI-only, ARB-only, and ACEI-ARB group, respectively (P < 0.001). The risk of cancer mortality in patients with ARB was only 0.124 (0.034-0.445) compared to that of non-users of ARB by Cox's hazard proportional analysis. In conclusion, prescription of ACEI or ARB in patients with GN does not increase cancer incidence and recipients of ARB show rather lower rates of all-cause mortality and cancer mortality.
Adult ; Aged ; Angiotensin II Type 1 Receptor Blockers/*therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/*therapeutic use ; Female ; Follow-Up Studies ; Glomerulonephritis/complications/diagnosis/*drug therapy ; Humans ; Incidence ; Kidney/pathology ; Male ; Middle Aged ; Neoplasms/complications/*epidemiology/mortality ; Renin-Angiotensin System/*drug effects ; Retrospective Studies ; Risk Factors

Adult ; Anticoagulants ; therapeutic use ; Carcinoma, Renal Cell ; complications ; pathology ; surgery ; Echocardiography ; Female ; Heart Atria ; diagnostic imaging ; pathology ; Humans ; Kidney Neoplasms ; complications ; pathology ; surgery ; Leiomyomatosis ; complications ; pathology ; surgery ; Thromboembolism ; diagnostic imaging ; drug therapy ; etiology ; Treatment Outcome ; Uterine Neoplasms ; complications ; pathology ; surgery