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Abramson Cancer CenterNCI CANCERLIT® Search: Kidney (Renal Cell) Cancer - September 2002
National Cancer Institute®
Last Modified: September 1, 2002
- The serine proteinase thrombin promotes migration of human renal carcinoma cells by a PKA-dependent mechanism.
- Not traditional prognostic factors in human conventional renal carcinoma.
- [Synchronous tumor of the upper urinary tract with bladder cancer. Opportunity for nephroureterectomy and block-cystectomy]
- [Tumors of the upper urinary tract: results of conservative surgery]
- Expression of human mucin genes in normal kidney and renal cell carcinoma.
- The TSC-2 product tuberin is expressed in lymphangioleiomyomatosis and angiomyolipoma.
- Immunohistochemical study of the expression of cell cycle regulating proteins at different stages of bladder cancer.
- Soluble immunological parameters and early prognosis of renal cell cancer patients.
- The usefulness of F-18 deoxyglucose whole-body positron emission tomography (PET) for re-staging of renal cell cancer.
- [Molecular portrait of human kidney carcinomas: the gene expression profiling of protein-tyrosine kinases and tyrosine phosphatases which
- Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors.
- Prognostic significance of nuclear morphometry in renal cell carcinoma.
- Contribution of grade, vascular invasion and age to outcome in clinically localized renal cell carcinoma.
- Gender as a prognostic factor in patients with renal cell carcinoma.
- CT differentiation of large exophytic renal angiomyolipomas and perirenal liposarcomas.
- Feasibility trial of methotrexate-paclitaxel as a second line therapy in advanced urothelial cancer.
- Salvage therapy for platinum-refractory urothelial cancer: designing new clinical trials.
- DNA hypermethylation at the D17S5 locus is not a frequent event in human urothelial cancer.
- Clinical and pathologic tumor size in renal cell carcinoma; difference, correlation, and analysis of the influencing factors.
- Multi-cytokine therapy for advanced renal cell carcinoma: determination of the minimal effective dose.
- [Surgical treatment of renal carcinoma and thrombosis of the inferior vena cava]
- [Renal carcinoma: active detection in regular check-ups]
- Gene expression profiling in silico: relative expression of candidate angiogenesis associated genes in renal cell carcinomas.
- Retroperitoneoscopic nephrectomy: the experience of an Irish teaching hospital.
- Thirteen-year, long-term efficacy of interferon 2alpha and interleukin 2-based home therapy in patients with advanced renal cell carcinoma.
- Suppression of NF-kappaB activation in normal T cells by supernatant fluid from human renal cell carcinomas.
- Renal cell carcinoma-derived gangliosides suppress nuclear factor-kappaB activation in T cells.
- Constitutive activation of nuclear factor-kappaB prevents TRAIL-induced apoptosis in renal cancer cells.
- Re: laparoscopic radical nephrectomy: cancer control for renal cell carcinoma.
- Re: long-term followup after laparoscopic radical nephrectomy.
- Unclassified renal cell carcinoma: clinical features and prognostic impact of a new histological subtype.
- Phase II trial of weekly intravenous gemcitabine administration with interferon and interleukin-2 immunotherapy for metastatic renal cell
- Doxorubicin and ifosfamide in patients with metastatic sarcomatoid renal cell carcinoma: a phase II study of the Genitourinary Group of the
- Renal cell carcinoma with tumor thrombus: is cytoreductive nephrectomy for advanced disease associated with an increased complication rate?
- [Surgical management of pancreatic metastasis from renal cell carcinoma]
- Renal cell neoplasia.
- Renal cell carcinoma.
- Cytokeratin 7: a useful adjunct in the diagnosis of chromophobe renal cell carcinoma.
- Ten-year survival results in metastatic renal cell cancer patients treated with monoimmunotherapy with subcutaneous low-dose interleukin-2.
- A pilot study of thalidomide in patients with progressive metastatic renal cell carcinoma.
- [Local immune tolerance mechanisms in kidney cancer]
- [Interleukin-2 and interferon in metastatic kidney cancer. Experience of the French Immunotherapy Group]
- Molecular cytogenetic analysis of clustered sporadic and familial renal cell carcinoma-associated 3q13 approximately q22 breakpoints.
- Expression of CD154 on renal cell carcinomas and effect on cell proliferation, motility and platelet-activating factor synthesis.
- Few FH mutations in sporadic counterparts of tumor types observed in hereditary leiomyomatosis and renal cell cancer families.
- Special focus session: multidetector CT: abdominal visceral imaging.
- High expression levels of insulin-like growth factor-I receptor predict poor survival among women with clear-cell renal cell carcinomas.
- HIF activation identifies early lesions in VHL kidneys: evidence for site-specific tumor suppressor function in the nephron.
- [Personal and histopathological factors as prognostic variables in upper urothelial tumors undergoing surgery]
- Unique patterns of allelic imbalance distinguish type 1 from type 2 sporadic papillary renal cell carcinoma.
- Phase I trial of interferon alpha2b and liposome-encapsulated all-trans retinoic acid in the treatment of patients with advanced renal cell
- Expression of cadherin-8 in renal cell carcinoma and fetal kidney.
- [Apoptosis in renal adenocarcinoma. Expression of bcl-2 in locally confined tumors]
- Phase II trial of pegylated-liposomal doxorubicin (Doxil) in renal cell cancer.
- Infrequent p53 gene mutations and lack of p53 protein expression in clear cell sarcoma of the kidney: immunohistochemical study and mutation
- Hypothermia and total body exsanguination: a cornerstone for the treatment of renal cell carcinoma with grade IV vascular extension.
- Flt-3 ligand and sequential FL/interleukin-2 in patients with metastatic renal carcinoma: clinical and biologic activity.
- Mobilization of dendritic cell precursors in patients with cancer by flt3 ligand allows the generation of higher yields of cultured dendritic
Table of Contents
1
UI - 12175550
AU - Kaufmann R; Junker U; Junker K; Nuske K; Ranke C; Zieger M; Scheele J
TI -
The serine proteinase thrombin promotes migration of human renal
carcinoma cells by a PKA-dependent mechanism.
SO - Cancer Lett 2002 Jun 28;180(2):183-90
AD - Department of General and Visceral Surgery, Medical Faculty at the
Friedrich Schiller University Jena, Bachstr. 18, 07740 Jena, Germany.
roland.kaufmann@med.uni-jena.de
In this study, we demonstrated that thrombin activates protein kinase C
(PKC), mitogen activated protein kinases (MAP kinases), transcription
factor nuclear factor-kappa B (NF-kappa B), and cAMP-dependent protein
kinase (PKA) in the human renal carcinoma cell line A-498. In addition,
it enhanced the migratory capacity, but had no effect on the
proliferation of A-498 cells. The effect of thrombin on migration could
be blocked by the PKA inhibitor H-89 but was not influenced by
inhibition of PKC, MAP kinases or NF-kappa B. We concluded, that
thrombin acts as a regulator on human A-498 renal carcinoma cell
migration including PKA.
2
UI - 11753249
AU - Cindolo L; Cantile M; Galasso R; Marsicano M; Napodano G; Altieri V
TI -
Not traditional prognostic factors in human conventional renal
carcinoma.
SO - Minerva Urol Nefrol 2001 Dec;53(4):211-9
AD - Clinica Urologica, Universita degli Studi di Napoli Federico II, Naples,
Italy. lucacindolo@virgilio.it
The evaluation of know prognostic factors is an essential step of the
assessment of the patients affected by primary renal carcinoma. As long
as the major biological mechanisms of renal carcinomas remain unknown,
it will be impossible to achieve an accurate prognostic judgement. The
TNM classification has always been the main source of information.
Nevertheless, recently several investigations evaluated the prognostic
power of serum and cellular markers. The aim of this study is to
identify those markers which show statistical reliability and can be
used in the clinical practice. A literature search was performed on
MEDLINE to identify potential not traditional prognostic factors for
keywords. We considered also articles cited in references of first
selected manuscript. The analysis of serum and cellular prognostic
markers does not allow the identification of specific factors, reliable,
independent, easy to dose, widely useful and whose informations are
repeatable. Currently classical prognostic factors (staging, grading,
hystologic type, patient clinical conditions, anaemia, presentation
modalities, etc.) represent the only useful elements after surgical time
in RCC patients. Among serum prognostic factors, CRP and ferritin play a
crucial role. These proteins appear ideal in monitoring the disease over
time, due to simple test execution and specimens repeatability. Among
RCC molecular markers, proliferation index result promising for their
reliability and reproducibility, the easy dosage and high series number
tested. Literature data suggest that the ideal marker for renal
carcinomas has not been identified yet. However, C-reactive protein,
ferritin and the proliferative activity indexes (Ki67 and AgNOR) appear
to be, at present, the best prognostic tools. To confirm obtained
results and to use biomolecolar markers on a routinary base further
studies on wide surgical series will be required. The improvement of
technical tool and costs reduction represent also a necessary step
toward the identification of efficient prognostic markers in RCC.
3
UI - 11852517
AU - Navas Pastor J; Garcia Ligero J; Garcia Garcia F; Tomas Ros M; Rico
TI -
Galiano JL; Sempere Gutierrez A; Gil Franco J; Fontana Compiano LO
[Synchronous tumor of the upper urinary tract with bladder cancer.
Opportunity for nephroureterectomy and block-cystectomy]
SO - Arch Esp Urol 2001 Dec;54(10):1095-102
AD - Servicio de Urologia, Hospital General Universitario, Murcia, Espana.
OBJECTIVE: One of the basic characteristics of urothelial carcinoma is
its tendency to synchronous or metachronous multifocality. Thus the need
to explore the entire urinary tract of patients with urothelial
neoformations. The aim of this article is to study the tumors of the
upper urinary tract that appear synchronously with infiltrating
carcinoma of the bladder. The clinicopathological characteristics and
the morbidity and mortality of en bloc surgery of both tumors are
analyzed. METHODS: A retrospective study was carried out on 170 radical
cystectomies for infiltrating bladder tumor performed in our department
over a 13-year period. Patient history, clinicopathological
characteristics, complementary tests, type of surgery performed,
postoperative complications and follow-up were analyzed. RESULTS: Tumor
of the upper urinary tract appeared in 14 (1 bilateral) of these
patients and were synchronous in 10 cases. All patients were male; mean
age 63 years. Three were localized in the pelvis, 2 in the proximal
ureter and 6 in the distal third. Diagnosis was made by IVP in 6
patients and by US and antegrade pyelography in the other 4 patients.
Nephroureterectomy and radical cystectomy were performed en bloc in 8
cases; 6 had a Bricker procedure and 2 ileal substitution. Salvage
radical cystectomy + distal ureterectomy were performed in the other two
patients. Two patients submitted to en bloc surgery had postoperative
complications; one presented prolonged ileua and the other required
surgery for retroperitoneal hemorrhage. The two patients submitted to
palliative surgery died of and sepsis during the postoperative period.
At 33 months' mean follow-up, 3 patients have shown tumor progression.
CONCLUSIONS: There is a high proportion of synchronous tumor of the
upper urinary tract in our series of patients with infiltrating
carcinoma of the bladder undergoing radical cystectomy, therefore we
consider it necessary to explore the entire urinary system. Surgical
removal of both tumors en bloc does not increase the morbidity and
mortality.
4
UI - 11859657
AU - Djokic M; Hadzi-Djokic J; Nikolic J; Dragicevic D; Durutovic O;
TI -
Radivojevic D
[Tumors of the upper urinary tract: results of conservative surgery]
SO - Prog Urol 2001 Dec;11(6):1231-8
AD - Centre clinique de la Serbie, Institut d'Urologie et de Nephrologie,
Belgrade, Yougoslavie. m2909d@EUnet.yu
OBJECTIVE: To determine the results of conservative surgery for upper
urinary tract urothelial tumours. PATIENTS AND METHODS: From 1986 to
1997, 352 patients were treated in the Belgrade urology clinic for upper
urinary tract urothelial tumour. 54 patients (15.3%) were treated by
conservative surgery. The sex ratio was 1.3 men for 1 woman. The mean
age was 63 years. In most cases, the tumour was situated in the ureter.
Conservative surgery was performed on principle in 60% of patients for a
small isolated lesion (solitary low-stage, low-grade tumour). In
contrast, in about 40% of cases, conservative surgery was performed by
necessity due to the presence of bilateral tumours, a solitary kidney or
renal failure related to Balkan nephropathy. The median follow-up was
67.3 months (range: 6 months-14 years). RESULTS: 15.8% of patients
developed a local recurrence during the follow-up period. The risk of
recurrence was higher when conservative surgery was performed for
indications of necessity than when it was performed on principle (21.7%
versus 11.8%), but the difference was not statistically significant (c2
test, t test). The stage and grade of differentiation were identified as
the most significant predictive factors for the risk of local
recurrence. The overall 5-year survival rate was 67% with more
favourable results in the case of conservative surgery performed on
principle compared conservative surgery by necessity (72% versus 60%).
The difference between these results was not statistically significant,
but a statistically significant difference was observed for tumour stage
and grade (grade III versus grade I and II, pT3 versus pT1, pT2). The
5-year survival probability was 68.5%. Recurrence was most likely to
occur during the early postoperative course, as 81.56% occurred during
the first 18 months. CONCLUSION: Urothelial tumours can be managed
conservatively. However, the risk of recurrence is directly correlated
with the tumour stage and grade, with a high level of statistical
significance, and with the type of indication for conservative surgery
performed, but with no statistically significant difference.
5
UI - 12010365
AU - Leroy X; Copin MC; Devisme L; Buisine MP; Aubert JP; Gosselin B; Porchet
TI -
N
Expression of human mucin genes in normal kidney and renal cell
carcinoma.
SO - Histopathology 2002 May;40(5):450-7
AD - Department of Pathology, University Hospital and Unity INSERM U 377,
Lille, France. x-leroy@chru-lille.fr
AIMS: Human mucins are large O-glycoproteins expressed by epithelial
cells. Mucins are thought to be implicated in cell protection, cell
adhesion and signalling. The aim of this study was to investigate the
expression of the human mucin genes (MUC1-4, 5AC, 5B, 6-7) in normal
kidney and renal cell carcinoma. METHODS AND RESULTS: We analysed by
in-situ hybridization, immunohistochemistry and reverse
transcriptase-polymerase chain reaction (RT-PCR) the expression of these
genes in normal adult kidney (n=14) and renal cell carcinomas (n=29).
MUC1, MUC3 and MUC6 were expressed both in normal kidney and in renal
carcinomas. In normal kidney, MUC1 was expressed in the distal
convoluted tubules and in collecting ducts, whereas MUC3 was restricted
to the proximal tubules. MUC4 was strongly expressed in epithelial
urothelial cells of pyelocalyceal cavities. MUC6 was only detected by
RT-PCR. In renal carcinoma, we showed a heterogeneous expression of MUC1
and MUC3 with an over-expression of MUC3 in renal clear cell carcinoma.
The level of MUC3 expression by in-situ hybridization was associated
with the nuclear grade in clear cell carcinoma. CONCLUSIONS: This study
is the first large series investigating human mucin gene expression in
the kidney. MUC1, MUC3 and MUC6 are expressed in normal and tumour
kidney. The over-expression of MUC3 in renal cell carcinomas favours its
implication in renal tumorigenesis.
6
UI - 12010366
AU - Johnson SR; Clelland CA; Ronan J; Tattersfield AE; Knox AJ
TI -
The TSC-2 product tuberin is expressed in lymphangioleiomyomatosis and
angiomyolipoma.
SO - Histopathology 2002 May;40(5):458-63
AD - Division of Therapeutics, University of Nottingham, UK.
simon.johnson@nottingham.ac.uk
AIMS: Lymphangioleiomyomatosis is categorized by proliferation of
abnormal smooth muscle cells (LAM cells) in the lungs and lymphatics and
the presence of angiomyolipomas. Recently mutations in the tuberous
sclerosis complex-2 gene (TSC-2) have been described in LAM cells and
angiomyolipomas. The TSC-2 protein tuberin is a tumour suppressor and
its loss may result in cellular proliferation. We used
immunohistochemistry to test the hypothesis that uncontrolled cellular
proliferation in lymphangioleiomyomatosis is the result of reduced
tuberin protein expression. METHODS AND RESULTS: Tissue from normal
lung, normal kidney, lymphangioleiomyomatosis and angiomyolipomas was
immunostained with three separate anti-tuberin antibodies. Tuberin
staining in normal tissues was similar to that previously described.
Surprisingly, tuberin was strongly expressed in the LAM cells of all
cases of lymphangioleiomyomatosis and angiomyolipoma at a greater level
than in normal smooth muscle cells. The perivascular cells of
angiomyolipomas, however, did not stain for tuberin. CONCLUSIONS: Our
results suggest that a loss of tuberin protein in LAM cells is not the
cause of the cellular proliferation seen in lymphangioleiomyomatosis.
Lymphangioleiomyomatosis may result either from the expression of a
mutant tuberin with abnormal function, as a result of mutations in
functionally related proteins, or from more than one mechanism.
7
UI - 12073046
AU - Primdahl H; von der Maase H; Sorensen FB; Wolf H; Orntoft TF
TI -
Immunohistochemical study of the expression of cell cycle regulating
proteins at different stages of bladder cancer.
SO - J Cancer Res Clin Oncol 2002 Jun;128(6):295-301
AD - Department of Clinical Biochemistry, Aarhus University Hospital at
Skejby, Aarhus N, Denmark.
PURPOSE: The cell cycle is known to be deregulated in cancer. We
therefore analyzed the expression of the cell cycle related proteins
p21, p27, p16, Rb, and L-myc by immunohistochemical staining of bladder
tumors. METHODS: The tissue material consisted of bladder tumors from
three groups of patients; group 1, 23 patients with recurrent stage Ta
(non-invasive) tumors; group 2, 22 patients presenting at their first
admission with T2-4 (muscle invasive) tumors; group 3, 24 patients who
experienced disease progression from Ta or T1 (invasive in connective
tissue) to a higher stage. By immunohistochemical staining the protein
expression was compared to allelic deletions of the corresponding genes.
The allelic deletions were detected by PCR-based microsatellite
analyses. RESULTS: We detected a significant reduction in the expression
levels of the cell cycle related proteins p21(waf1) ( P=0.002),
p27(kip1) ( P=0.03), Rb ( P=0.00002), and L-myc ( P=0.00000007) in
muscle invasive tumors compared to noninvasive tumors. Tumors presenting
as muscle invasive at first diagnosis had significantly lower levels of
p16/CDKN2A ( P=0.01) when compared to muscle invasive tumors that
followed Ta or T1 precursor lesions. We found no general correlation
between allelic deletion of a gene and its immunohistochemical protein
expression, indicating that the remaining allele may be capable of
encoding a normal or even increased protein level. CONCLUSIONS: Our
results support the hypothesis that bladder tumors with invasion at
first diagnosis differ from those in which invasion follow superficial
tumors. This difference is reflected as a different level in cell cycle
related protein expression. The data also indicate that allelic
deletions of cell cycle related genes do not correlate with an altered
level of protein expression.
8
UI - 11876546
AU - Kallio JP; Tammela TL; Marttinen AT; Kellokumpu-Lehtinen PL
TI -
Soluble immunological parameters and early prognosis of renal cell
cancer patients.
SO - J Exp Clin Cancer Res 2001 Dec;20(4):523-8
AD - Division of Urology, Tampere University Hospital, University of Tampere,
Finland.
In local or metastatic cancer, a prognostic tumour marker could be a
valuable tool in the selection of different treatments. In renal cell
cancer (RCC) no such markers have been available. We therefore evaluated
the association between several pretreatment serum markers, tumour
classification and short term survival in RCC patients. Serum samples
were collected before surgery and three months thereafter from 24 RCC
patients. Interleukin-6 (IL-6), IL- 12, soluble IL-2 receptor (sIL-2R)
and intercellular adhesion molecule-1 (sICAM-1) were measured in serum
samples using specific commercial enzyme immunoassay kits. Serum IL-6,
sIL-2R and sICAM-1 levels before nephrectomy were significantly higher
in non-local tumours than in local ones (mean IL-6 53 pg/ml versus 6.3
pg/ml, and sICAM-1 443 ng/ml versus 290 ng/ml, sIL-2R 3779 pg/ml versus
1796 pg/ml). In contrast, IL-12 levels were higher in local tumours (148
versus 102 pg/ml) and the levels increased significantly (P < 0.005)
after removal of the primary tumour in patients with local disease. All
patients with local tumours had normal IL-6 values, while only one with
a non-local tumour had IL-6 levels below 10 pg/ml. In addition, IL-6 and
sICAM-1 levels before operation were significantly higher in patients
with short (less than one year) survival (p=0.007 to IL-6 and p=0.006 to
sICAM-1). In contrast, patients with shorter survival had significantly
lower IL-12 (p=0.03) levels. Our findings suggest that RCC induces
changes in several immunological parameters. These soluble immunological
factors, IL-6, IL-12, sIL-2R and sICAM-1, might have a role as
prognostic factors in RCC.
9
UI - 11837802
AU - Safaei A; Figlin R; Hoh CK; Silverman DH; Seltzer M; Phelps ME; Czernin
TI -
J
The usefulness of F-18 deoxyglucose whole-body positron emission
tomography (PET) for re-staging of renal cell cancer.
SO - Clin Nephrol 2002 Jan;57(1):56-62
AD - Ahmanson Biological Imaging Clinic/Nuclear Medicine, Department of
Molecular and Medical Pharmacology, UCLA School of Medicine, Los
Angeles, CA 90095-6948, USA.
PURPOSE: The use of whole-body PET for re-staging of renal cell
carcinoma has not been investigated. The aim of the current study was to
examine the diagnostic accuracy and clinical usefulness of whole-body
PET imaging for re-staging of renal cell cancer. PATIENTS AND METHODS:
Clinical PET was performed for re-staging in 36 patients with advanced
renal cell cancer. Written reports of imaging studies (including CT,
MRI, US, plain film and bone scan), patient history, and extensive chart
notes were used to define the clinical stage before PET (pre-PET stage).
The written PET report was used to define the clinical stage after PET
(PET stage). Reports were used to determine the accuracy of PET for
re-staging renal cell cancer and for defining biopsy proven lesions.
Clinical parameters and biopsy proven lesions served as reference for
the accuracy of PET for re-staging renal cell cancer. RESULTS: PET
classified the clinical stage correctly in 32/36 patients (89%) and was
incorrect in 4/36 (11%) (sensitivity and specificity: 87% and 100%). In
20 patients, 25 suspicious lesions were biopsied within 3.2 +/- 6.7
months of the PET study. Of these, 17 were malignant and 8 were benign.
PET correctly classified 21/25 (84%) of the biopsied lesions
(sensitivity and specificity: 88% and 75%). CONCLUSION: PET re-stages
renal cell cancer with a diagnostic accuracy of 89%. Its diagnostic
accuracy for classifying biopsy proven anatomic lesions as malignant or
benign was 84%. These findings suggest that PET is useful in
characterizing anatomic lesions of unknown significance in patients with
renal cell cancer.
10
UI - 12068634
AU - Cheburkin IuV; Kniazeva TG; Peter S; Kniazev IuP; Karelin MI; Shkol'nik
TI -
MI; Evtushenko VI; Hanson KP; Ullrich A; Kniazev PG
[Molecular portrait of human kidney carcinomas: the gene expression
profiling of protein-tyrosine kinases and tyrosine phosphatases which
controlled regulatory signals in the cells]
SO - Mol Biol (Mosk) 2002 May-Jun;36(3):480-90
AD - Research Institute of Roentgenology and Radiology, Ministry of Health of
the Russian Federation, St. Petersburg, 197758 Russia.
Hybridization with cDNA arrays was used to obtain expression profiles of
214 protein-tyrosine kinase, protein-tyrosine phosphatase, dual-specific
phosphatase, and other genes for kidney carcinomas (KC) and normal
kidney tissues of 34 patients and for seven carcinoma cell lines.
Computer analysis revealed three clusters of genes coexpressed in KC. A
proliferating-cell gene cluster included MET, VIM, MYC, TOP2A, PCNA,
etc. A neoangiogenesis and blood-cell gene cluster included LCK, HCK,
FGR, MMP9, CSFR1, VEGF, FLT1, and KDR. A cluster corresponding to
normal, differentiated kidney cells included ERBB2 (HER2) for receptor
protein-tyrosine kinase, several phosphatase genes (PTPRE, PTPRB,
DUSP9), and EGF. The results suggested that MET, DUSP9, PCNA, TOP2A, and
VIM may serve as diagnostic and prognostic markers in KC. Tubulin and
topoisomerase II were assumed to be promising targets for cell
proliferation inhibitors in KC.
11
UI - 12074796
AU - Murota T; Kawakita M; Oguchi N; Shimada O; Danno S; Fujita I; Matsuda T
TI -
Retroperitoneoscopic partial nephrectomy using microwave coagulation for
small renal tumors.
SO - Eur Urol 2002 May;41(5):540-5; discussion 545
AD - Department of Urology, Kansai Medical University, 10-15 Fumizono,
Moriguchi, Osaka 570-8507, Japan.
OBJECTIVES: The outcome of laparoscopic partial nephrectomy using a
microwave tissue coagulator for treatment of small renal tumors was
with small renal tumors of less than 5.0cm in diameter (1.0-5.0cm,
T1N0M0) underwent retroperitoneoscopic partial nephrectomy. To control
bleeding during the partial nephrectomy, the renal parenchyma around the
tumor was coagulated using a microwave tissue coagulator with a needle
of 1.5cm length. The tumor was circumscribed within the coagulated area
with 8-13 punctures of the coagulation needle, and partial nephrectomy
was performed using scissors and bipolar forceps.RESULTS: All eight
patients successfully underwent the procedure retroperitoneoscopically.
The average operative time was 295 minutes and the average blood loss
was 129ml. Three patients showed urine leakage from the renal calyces,
which was controlled by suturing retroperitoneoscopically. In two
patients, the surgical margin was revealed to be positive for renal cell
carcinoma by frozen section pathology and additional resection was
performed in these individuals. The patients were discharged from the
hospital with almost full convalescence on day 10 on average. Within the
mean follow-up period of 10.4 months, no recurrence was found when
examined with computer tomography (CT) using contrast media. As a
complication, one patient experienced a decrease in function of the
operated kidney caused by unknown reason.CONCLUSION: Retroperitoneal
partial nephrectomy using a microwave tissue coagulator is useful for
treatment of small renal tumors located at the peripheral area of the
kidney. Bleeding from the renal parenchymal incision site is well
controlled without occlusion of the renal artery with additional use of
a bipolar coagulator, when necessary. Further experience and long-term
follow-up are mandatory however, to establish the usefulness of this
technique.
12
UI - 12081763
AU - Ozer E; Yorukoglu K; Sagol O; Mungan U; Demirel D; Tuzel E; Kirkali Z
TI -
Prognostic significance of nuclear morphometry in renal cell carcinoma.
SO - BJU Int 2002 Jul;90(1):20-5
AD - Department of Pathology, Dokuz Eylul University School of Medicine,
Inciralti, Izmir, Turkey.
OBJECTIVE: To assess nuclear morphometry as a predictor of prognosis in
patients with renal cell carcinoma (RCC). PATIENTS AND METHODS: The
study included 65 consecutive patients with RCC who underwent radical
nephrectomy and were followed up for a median (range) of 80 (27-138)
months. Nuclear morphometry was assessed using a computer-assisted image
analysis system on histological sections and characterized by five
nuclear variables (area, perimeter, major and minor diameter, and form
factor). From the patients' records and pathology specimens, the
clinicopathological prognostic variables (histological type, Fuhrman
grade and pathological stage) were recorded. The proliferative activity
was assessed using immunohistochemical staining with Ki-67 antibody.
RESULTS: Higher values of mean nuclear area, perimeter, and major and
minor diameter were significantly related to higher nuclear grade,
proliferative activity and advanced tumour stage. They were significant
predictors of disease progression and survival, together with grade,
stage, sarcomatoid histology and proliferative activity. Of all
significant prognostic factors predicting progression-free survival,
only stage was independent (T4 vs T1, hazard ratio 6.55, 95% CI
1.63-26.13, P=0.008). CONCLUSION: Although the significance of these
preliminary results must not be overstated, nuclear morphometry might
provide significant prognostic information in predicting survival and
tumours at high risk of progression in RCC.
13
UI - 12081764
AU - Griffiths DF; Verghese A; Golash A; Kynaston HG; Matthews PN; Hart AJ;
TI -
Court JB
Contribution of grade, vascular invasion and age to outcome in
clinically localized renal cell carcinoma.
SO - BJU Int 2002 Jul;90(1):26-31
AD - Department of Pathology, University of Wales College of Medicine,
Cardiff, UK. griffithsdfr@cardiff.ac.uk
OBJECTIVE: To determine the relative prognostic importance of
microvascular invasion in apparently localized renal cell carcinoma
(RCC). PATIENTS AND METHODS: A retrospective clinical and pathological
review was conducted of 176 consecutive patients identified from
pathology records who had a nephrectomy for RCC with a median follow-up
of 44 months. Vascular invasion was recorded and categorized by the
level of microvascular invasion (MVI), renal vein invasion (RVI) and
inferior vena cava invasion (IVCI). Tumour type, grade and size were
also assessed. These variables were assessed by univariate and
multivariate analysis to determine their effect on disease-free
survival. RESULTS: In the univariate analysis tumour size, grade,
vascular invasion and young age each predicted reduced disease-free
survival. On multivariate analysis for all 176 patients, grade, vascular
invasion and young age were the significant independent predictors of
reduced disease-free survival. In a subgroup of 149 patients from whom
those with very high risk determinants were excluded (those with grade 4
tumours and/or IVCI) most of the risk of metastasis could be accounted
for by vascular invasion and young age alone (MVI vs no vascular
invasion, hazard ratio 3.18, 95% confidence interval 1.29-7.84; RVI vs
no vascular invasion 2.41, 0.989-5.89; and age per year 0.963,
0.94-0.992). CONCLUSIONS: Grade, vascular invasion and young age are the
main independent predictors of relapse in clinically localized RCC after
nephrectomy. For most patients, who do not have very high risk
indicators, the main adverse predictors are vascular invasion and young
age. These findings are important when selecting patients for trials of
adjuvant therapy and have implications for pathological staging.
14
UI - 12081765
AU - Onishi T; Oishi Y; Goto H; Yanada S; Abe K
TI -
Gender as a prognostic factor in patients with renal cell carcinoma.
SO - BJU Int 2002 Jul;90(1):32-6
AD - Department of Urology, Aoto University Hospital, Jikei University School
of Medicine, Tokyo, Japan. onishi@jikei.ac.jp
OBJECTIVE: To evaluate gender as a prognostic factor in patients with
renal cell carcinoma (RCC), using a retrospective review of patients
with RCC stratified according to gender and analysing factors affecting
patients with pathologically defined RCC (all of whom underwent
nephrectomy) were classified as having clear cell carcinoma in 662
(follow-up in 648), papillary RCC in 43 (follow-up in 42), chromophobe
cell carcinoma in 36 (follow-up in 34) and cyst-associated RCC in 27
(all followed up) according to the criteria proposed by the World Health
Organization. The survival rates were compared between men and women,
calculated and stratified according to the subtype of RCC. RESULTS:
There tended to be a more favourable prognosis in women than in men but
the difference was not quite significant (P=0.061). Of those with clear
cell carcinoma, women had a more favourable prognosis than men and the
difference in survival was significant (P=0.012). No other subtype of
RCC was associated with a significant difference in survival between the
sexes. There was a smaller proportion of patients with stage IV and a
larger proportion with stage I disease in women than in men (P<0.05). Of
stage I patients, women had a more favourable prognosis than men
(P<0.011). Women had better survival after recurrence than had men, the
difference being significant (P=0.007). CONCLUSION: The prognosis is
significantly better in women than men with clear cell carcinoma. The
factors that contribute to a favourable prognosis in women are the
greater proportion of lower stage disease and better survival after
recurrence.
15
UI - 12185060
AU - Israel GM; Bosniak MA; Slywotzky CM; Rosen RJ
TI -
CT differentiation of large exophytic renal angiomyolipomas and
perirenal liposarcomas.
SO - AJR Am J Roentgenol 2002 Sep;179(3):769-73
AD - Department of Radiology, Division of Abdominal Imaging, HW 202, New York
University Medical Center, 560 First Ave., New York, NY 10016, USA.
OBJECTIVE: The purpose of our study was to describe the imaging findings
and CT characteristics that lead to accurate distinction of large
exophytic renal angiomyolipomas from retroperitoneal perirenal
liposarcomas, which at times can be confused on imaging studies and even
at pathologic examination. MATERIALS AND METHODS: We retrospectively
analyzed CT images of 15 large exophytic renal angiomyolipomas and 12
well-differentiated perirenal liposarcomas. Pathologic correlation was
available for six of 15 angiomyolipomas and all of the liposarcomas. All
examinations were evaluated for lesion size, renal parenchymal defect,
enlarged vessels, kidney displacement, lesion encapsulation or
margination, associated hemorrhage, and additional angiomyolipomas. The
records of patients with tuberous sclerosis or the forme fruste of that
condition were excluded from the study. RESULTS: The average size of the
angiomyolipomas was 14 x 10 cm. They showed a renal parenchymal defect
(n = 15), enlarged vessels (n = 12), renal displacement (n = 14), good
margination without a distinct capsule (n = 14), hemorrhage (n = 1), and
additional (one or two) angiomyolipomas (n = 4). The average size of the
liposarcomas was 18 x 11.6 cm. They showed enlarged vessels (n = 3),
renal displacement (n = 11), and encapsulation (n = 4); none showed a
renal parenchymal defect, hemorrhage, or associated angiomyolipomas.
CONCLUSION: Although large exophytic angiomyolipomas and
well-differentiated retroperitoneal liposarcomas may have similar
appearances on imaging, careful evaluation for a defect in the renal
parenchyma combined with the presence of enlarged vessels in
angiomyolipomas should enable accurate differentiation in almost all
cases. Achieving an accurate diagnosis can have a significant impact on
patient treatment.
16
UI - 12197223
AU - Bellmunt J; Cos J; Cleries R; Perez M; Ribas A; Eres N; Murio JE;
TI -
Margarit C; Baselga J
Feasibility trial of methotrexate-paclitaxel as a second line therapy in
advanced urothelial cancer.
SO - Cancer Invest 2002;20(5-6):673-85
AD - Medical Oncology Service, Hospital General Universitari Vall d'Hebron,
Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
bellmunt@hg.vhebron.es
To evaluate the clinical value of the concurrent use of methotrexate
administered immediately before paclitaxel, we investigated the efficacy
and toxicity of this two-drug combination administered as palliative
second line therapy in patients with advanced urothelial cancer. The
design of the schedule and sequence used was based on our previous
preclinical data from a comparative study on sequential combinations of
paclitaxel and methotrexate in a human bladder cancer cell line. As a
confirmation study, we further extended our analysis of in vitro
synergism. Twenty patients with advanced transitional cell carcinoma of
the urinary tract previously treated with platinum-based therapy, with
adequate renal function and a performance status > or = 60 were
considered eligible. They received therapy with methotrexate 30 mg/m2
administered as an intravenous bolus, followed immediately by paclitaxel
175 mg/m2 given as a 3-hr infusion, both on day 1 every 21 days. Therapy
was given on a compassionate-use basis until either disease progression
was documented or the patient became intolerant to therapy. In vitro
data were further analyzed using the median-effect principle and the
combination index method. Twenty patients with metastatic (16 patients)
or locally advanced disease (four patients) received a median of three
cycles of therapy. Of the 19 patients assessable for response, there
were six partial responses and seven disease stabilizations with no
complete responses. Median duration of response was 3 months (range,
2-7) and median survival was 5 months. Three patients developed grade
3-4 neutropenia, one patient had grade 3 anemia, four patients had grade
2-3 sensory neuropathy, and three patients had myalgias. Eighteen
patients developed alopecia. Gastrointestinal toxicity was mild. One
patient died after the first cycle due to pulmonary thrombo-embolism and
could not be evaluated for response. The synergistic in vitro effect of
the concurrent combination was confirmed in analyses performed under
mutually exclusive and mutually nonexclusive criteria. In conclusion,
the combination of methotrexate and paclitaxel at this dose and sequence
is feasible and active as a palliative therapy in patients with advanced
urothelial cancer previously treated with platinum-based therapies. This
schedule merits further investigation in a phase-II trial.
17
UI - 12197246
AU - Petrylak DP
TI -
Salvage therapy for platinum-refractory urothelial cancer: designing new
clinical trials.
SO - Cancer Invest 2002;20(5-6):855-6
18
UI - 12133074
AU - Bernues M; Casadevall C; Caballin MR; Egozcue J; Miro R
TI -
DNA hypermethylation at the D17S5 locus is not a frequent event in human
urothelial cancer.
SO - BJU Int 2002 Aug;90(3):332-5
AD - Institut de Biologia Fonamental, Universitat Autonoma de Barcelona,
Barcelona, Spain. marta@hsd.es
OBJECTIVE: To analyse the DNA methylation status and the loss of
heterozygosity (LOH) at the D17S5 locus (17p13.3) in urothelial cancer.
MATERIALS AND METHODS: DNA methylation was assayed and LOH analysed by
Southern blotting in a series of 33 transitional cell carcinomas of the
bladder and renal pelvis. RESULTS: DNA hypermethylation and LOH at the
D17S5 locus were detected in six (18%) and 17 (52%) of the tumours,
respectively. The six cases with DNA hypermethylation were of the
papillary type, and four also had LOH at this locus. CONCLUSION: In
contrast to other epithelial tumours, DNA hypermethylation at the D17S5
locus is not a frequent event in human urothelial cancer.
19
UI - 12100917
AU - Yaycioglu O; Rutman MP; Balasubramaniam M; Peters KM; Gonzalez JA
TI -
Clinical and pathologic tumor size in renal cell carcinoma; difference,
correlation, and analysis of the influencing factors.
SO - Urology 2002 Jul;60(1):33-8
AD - Department of Urology, William Beaumont Hospital, Royal Oak, Michigan,
USA.
OBJECTIVES: To investigate the relation between the clinical and
pathologic size and to identify the factors that affect this
relationship. The clinical size of the tumor is essential for choosing
the appropriate treatment in renal cell carcinoma. The pathologic size,
on the other hand, is an important prognostic indicator. METHODS: We
reviewed the charts of 291 open nephrectomy patients treated for
nonmetastatic renal cell carcinoma. Clinical size was defined as the
largest diameter on contrast-enhanced computed tomography. Pathologic
size was defined as the largest diameter on pathologic examination. The
clinical and pathologic sizes were compared, and their correlation was
analyzed. The effect of various clinical and pathologic factors on the
percentage of the size difference (%Delta(size)) was analyzed. RESULTS:
The mean clinical and pathologic size was 5.4 +/- 3.2 and 5.3 +/- 3.3
cm, respectively. The difference was not significant (P = 0.1679). The
clinical and pathologic size also correlated highly (r = 0.9540; P
<0.0001). The estimated blood loss, local tumor extension, and cell type
had significant influence on the %Delta(size) (P = 0.0018, 0.0415, and
0.0079, respectively). Additionally, in approximately one half of the
patients with the greatest size difference, features such as cystic
masses, hemorrhage, pyelonephritis, localization near or invasion of the
collecting system, cysts or dilated calices adjacent to the tumor, and
multiple cysts within the kidney were present, which were identified as
factors that might have influenced the accuracy of the clinical size.
CONCLUSIONS: The overall accuracy of the clinical size and its
correlation with the pathologic size was acceptable. However, the
presence of the above-mentioned factors should be taken into
consideration during the interpretation of clinical tumor size.
20
UI - 12174939
AU - Hamada I; Kato M; Okada K
TI -
Multi-cytokine therapy for advanced renal cell carcinoma: determination
of the minimal effective dose.
SO - Anticancer Res 2002 Jul-Aug;22(4):2429-36
AD - Department of Urology, Saitama Medical School, Iruma-Gun, Japan.
A low-dose cytokine combination therapy was given continuously for as
extended period to seven patients with advanced renal cell carcinoma to
investigate adverse reactions and anti-cancer effectiveness. These cases
were: five patients with metastasis; one whose surgical removal of
metastatic foci resulted in a non-curative operation; and one patient
administered our regimen as postoperative treatment for locally-advanced
cancer. Our regimen was started with a subcutaneous injection of a
two-drug combination: 6x10(6) units interferon-alfa (IFN-alpha) and
1x10(6) units interferon-gamma (IFN-gamma) to per week iwall our
patients; subcutaneous injection of 1.4x10(6) units interleukin-2 (IL-2)
per week was added for three patients who showed insufficient
therapeutic effects. The combination therapy was performed for 31 months
maximum. Objective adverse reactions were very slight in all patients,
thus they could be treated as outpatients. Therapeutic outcomes of
IFN-alpha and IFN-gamma combination therapy were assessed as CR in one,
PR in one, NC in 2 and PID in one patient. One patient showed NC for 27
months. Three patients, one PR case, one NC case and one PD case, were
shifted to the three-drug combination therapy and the results after
shifting were assessed as 2 PR cases and one PD case. These 2 PR cases
are still under treatment with a good quality of life after 31 and 24
months, respectively. These results suggest the possibility of
prolonging survival-time by combining continuous low-dose cytokine with
conventional local treatments.
21
UI - 12197170
AU - Balaz V; Schlegel D; Hampl F; Vrsansky D
TI -
[Surgical treatment of renal carcinoma and thrombosis of the inferior
vena cava]
SO - Rozhl Chir 2002 Jul;81(7):352-6
AD - Urologicke oddelenie NsP F. D. Roosevelta, Banska Bystrica, Slovenska
republika. vbalaz@stonline.sk
INTRODUCTION: In Slovakia every year some 600 renal carcinomas are
diagnosed. This number includes 5 to 10% carcinomas with a tumours
thrombus is the renal vein or inferior vena cava. The objective of the
present work is to describe diagnostic and surgical methods is patients
with this disease. MATERIAL AND METHODS: The authors describe the
surgical procedures, depending on the level of the tumours thrombus in
the inferior vena cava in a group of 22 patients operated at the
Urological department of the F. D. Roosevelt Hospital in Banska Bystrica
in 1997 to 2001. RESULTS: In all 22 patients the tumours thrombus was
removed along with the tumours kidney. In two instances the thrombus
reached as far as the right atrium and in 4 patients with a tumours
thrombus in a subdiaphragmatic position extracorporeal circulation was
used. There was no death in conjunction with the surgical operation.
There was one complication caused by haemorrhage which called for
surgical revision. Eight patients died during the investigation period
as a result of a relapse and generalization of the disease. CONCLUSION:
Based on the authors' experience and data in the literature the authors
recommend surgery of the kidney with a tumours thrombus of the inferior
vena cava as safe treatment in special hospital departments.
22
UI - 12043233
AU - Markina EA; Odintsov SV; Vinogradova NN
TI -
[Renal carcinoma: active detection in regular check-ups]
SO - Ter Arkh 2002;74(4):22-5
AIM: To improve early diagnosis of renal carcinoma (RC) in the course of
check-ups. MATERIAL AND METHODS: Regular checkups performed in 1980-1999
detected 715 cases of renal carcinoma. Among the patients were 452 male
(60.2%) and 263 female (39.8%) patients. Mean age was 66 years.
Screening methods for healthy examinees and risk group examinees, RC
incidence rate, 1 year lethality and survival were assessed. RESULTS:
Mean RC incidence rate in men was 80.9, in women 34.9 per 100,000. Early
diagnosis of RC stage I and II made up 58.4 in men and 59.4% in women.
Significantly more patients with RC stage I and II were diagnosed at
checkup than among those seeking medical advice. 5-year corrected
survival in males was 80%, 10-year survival--74%, in females--84 and
80%, respectively. CONCLUSION: Check-up raised early diagnosis of RC
stage I and II up to 82.3%. This, in its turn, improved survival of RC
patients.
23
UI - 11937758
AU - Gerritsen ME; Peale FV Jr; Wu T
TI -
Gene expression profiling in silico: relative expression of candidate
angiogenesis associated genes in renal cell carcinomas.
SO - Exp Nephrol 2002;10(2):114-9
AD - Department of Cardiovascular Research, Genentech, South San Francisco,
CA, USA. meg570@attbi.com
Recent advances in gene expression profiling have led to the development
of comprehensive databases which can be queried in various manners. In
the present report, we have taken a list of genes previously associated
with angiogenesis, either in in vivo or in in vitro models, and queried
a commercial database established by GeneLogic to determine the relative
expression of these candidate genes in normal kidneys and in renal cell
carcinomas (RCC). We identified a number of genes, including CXCR4,
matrix metalloproteinase 9, thrombospondin 2, and vascular endothelial
growth factor, that were highly expressed in RCC versus normal tissue.
One gene, hevin, appears to be selectively upregulated in RCC in
contrast to downregulation of this gene in lung and colon tumors. This
approach provides a powerful means to identify potential markers of
tumor vascularization. Copyright 2002 S. Karger AG, Basel
24
UI - 12173893
AU - Foley KA; El-Jack MS; Hegarty J
TI -
Retroperitoneoscopic nephrectomy: the experience of an Irish teaching
hospital.
SO - Ir J Med Sci 2002 Apr-Jun;171(2):76-8
AD - Department of Surgery, Waterford Regional Hospital, Ireland.
foleyka@hotmail.com
BACKGROUND: Since its introduction, laparoscopic nephrectomy is
increasingly being used worldwide as a method of removing the kidney,
both in benign disease and in small volume tumours. To our knowledge, we
are the first surgeons in Ireland to perform this procedure with results
that support its use in select cases. AIMS: We looked at 12 cases of
retroperitoneal laparoscopic nephrectomy, which we carried out over a
five-year period. METHODS: Of the 12 cases performed, five were for
renal cell carcinoma and seven were for benign disease. Regarding
patients with carcinoma, careful patient selection was based on physical
examination, biochemical renal profile and tumour stage. RESULTS: Mean
tumour size was 3.3cm. Mean specimen weight was 184g (carcinoma) and 42g
(benign). Mean surgical time was 90 minutes and average blood loss was
45ml. Average length of hospital stay was 3.5 days. No major
complications occurred. Follow-up of those with renal cell carcinoma
revealed all to be tumour-free and renal profile studies of all patients
fell within the normal range for all parameters. CONCLUSIONS: Our
results support previous reports that recommend laparoscopic nephrectomy
as a method for removing kidneys with benign disease or with small
volume carcinomas.
25
UI - 12209689
AU - Atzpodien J; Hoffmann R; Franzke M; Stief C; Wandert T; Reitz M
TI -
Thirteen-year, long-term efficacy of interferon 2alpha and interleukin
2-based home therapy in patients with advanced renal cell carcinoma.
SO - Cancer 2002 Sep 1;95(5):1045-50
AD - Medizinische Hochschule Hannover, Germany. sekrprofatzpodien@yahoo.de
BACKGROUND: The goal of the current report was to demonstrate the
long-term efficacy of outpatient subcutaneous (sc) interferon alpha
(IFN-alpha) and sc interleukin 2 (IL-2)-based combination regimens in
patients with metastatic renal cell carcinoma. METHODS: In three
consecutive clinical trials, 443 patients received combined sc IFN-alpha
and sc IL-2 (n = 97 patients); combined sc IFN-alpha, sc IL-2, and
intravenous (iv) 5-fluorouracil (5-FU) (n = 260 patients); or combined
sc IFN-alpha, sc IL-2, and iv 5-FU with oral 13cis-retinoic acid (n = 86
patients). RESULTS: The median overall survival was 21+ months. The
2-year, 5-year, and 13-year survival rates were calculated at 45.26%,
15.96%, and 8.96%, respectively. The median time to disease progression
was 6 months. The 2-year, 5-year, and 13-year progression free survival
rates were 17.84%, 9.54%, and 9.20%, respectively. CONCLUSIONS: The
current data suggest that combined outpatient sc IFN-alpha and sc IL-2,
according to the Atzpodien regimen, achieves long-term survival benefits
in a subset of patients with metastatic renal cell carcinoma, both with
and without 13-cis-retinoic acid and/or 5-fluorouracil. Copyright 2002
American Cancer Society.
26
UI - 10402173
AU - Kim HJ; Park JK; Kim YG
TI -
Suppression of NF-kappaB activation in normal T cells by supernatant
fluid from human renal cell carcinomas.
SO - J Korean Med Sci 1999 Jun;14(3):299-303
AD - Department of Urology, Institute for Medical Science, Chonbuk National
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