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Introduction
Published in Trevor F. Cox, Medical Statistics for Cancer Studies, 2022
Cancer is a dreaded disease. One in two people will be diagnosed with cancer within their lifetime. There are over 200 different types of cancer, however, and they are often grouped together under one name. For example, kidney cancer, otherwise known as renal cell cancer, can be of three main types: clear cell, papillary and chromophobe, but there are also some rare types of renal cell cancers. After grouping some of the cancers together, there are probably about 100 cancers.
Neoplasia in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Several histologic types of vaginal cancer, although rare, tend to occur more commonly than squamous cell carcinoma in women of reproductive age. Adenocarcinoma, usually of the clear cell variety, may develop after in utero exposure to diethylstilbestrol. The link between diethylstilbestrol exposure and clear cell adenocarcinoma of the lower genital tract, including the cervix, was well established by 1971, after which the use of diethylstilbestrol during pregnancy was discontinued. The risk of developing adenocarcinoma of the vagina or cervix is actually less than 1 in 1000 for those exposed to the transplacental carcinogen diethylstilbestrol. Approximately one-third of diethylstilbestrol-exposed patients develop adenosis, which may be a precursor to clear cell carcinoma. Such diethylstilbestrol-linked malignancies rarely occur before 14 years of age or after 30 years of age. Thus, frequent cervical and vaginal cytology with careful colposcopic evaluation for abnormal findings are indicated beginning at menarche. Most clear cell adenocarcinomas are diagnosed early (stage I) and thus have a good prognosis with an 80% 5-year survival. In pregnancy, treatment is largely unaltered, as surgery is performed without fetal regard, unless in the final trimester, in which case delay until after delivery may be contemplated.
Renal Cell Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Renal parenchymal tumors were originally considered to arise from ectopic adrenal nests, hence the coining of the term hypernephroma. In 1960, on the basis of electron microscopic features, Oberling et al. demonstrated a proximal renal tubular origin, and tumors were renamed renal cell adenocarcinoma or renal cell carcinoma (RCC).4 Subsequently, RCC has been further reclassified and subdivided into a number of differing subtypes with distinct histopathological, clinical, and molecular features. The World Health Organisation introduced a number of new sub-types in the 2016 classification which are listed in Table 18.1. However clear-cell tumors are by far the most common renal carcinomas and together with papillary and chromophobe subtypes account for more than 90% of renal carcinomas.5
Effectiveness of oral etoposide in recurrent or refractory epithelial ovarian cancer, primary peritoneal cancer and fallopian tube cancer
Published in Journal of Obstetrics and Gynaecology, 2022
Chompunoot Kongsawatvorakul, Chuenkamon Charakorn, Suwicha Chittithaworn, Arb-Aroon Lertkhachonsuk
Compared with other study conducted in Thailand, Thavaramara et al. reported 4.8 months (range 3.3–6.4 months) of PFS for a daily dose of 75 mg of oral etoposide (Thavaramara et al. 2009). Besides the difference in dosage, other factors can also contribute to such difference. For example, 52% of their patients were prescribed oral etoposide as the second-line treatment, whereas around half of our patients were treated as the third-line chemotherapy. Our study included 13 patients who received one cycle of oral etoposide while Thavaramara et al. excluded them. Moreover, the majority of histopathological subtypes were different; serous carcinoma and clear cell carcinoma accounted for two-thirds of our included patients, but serous carcinoma and endometrioid carcinoma accounted for half of theirs. Also study of Bozkaya et al. with majority of serous papillary carcinoma subtypes has slightly longer OS and PFS (Bozkaya et al. 2017). We hypothesised that clear cell carcinoma which has a worse prognosis played an important role in this response. The comparison of previous retrospective studies to this study is shown in Table 3.
Impact of parity on the incidence of ovarian cancer subtypes: a population-based case–control study
Published in Acta Oncologica, 2021
Vasileios Toufakis, Sushmita Katuwal, Eero Pukkala, Juha S. Tapanainen
It is well known that multiparity reduces the risk of ovarian cancer, especially that of epithelial cancer [2–5,15,16]. Our results support these observations as the parity decreased the risk of all epithelial cancer subtypes in women aged <55. The risk decrease was about 70% in clear-cell cancer and 40%-50% in the other subtypes. In women aged 55+, parous women also had reduced ORs, most strongly in clear-cell cancer. Furthermore, compared to women with one birth, increasing parity decreased the OR of especially serous cancer in both age groups and clear-cell cancer in premenopausal women. In the Million Women Study [3], parous women had an estimated 26% lower risk of ovarian cancer than nulliparous women and each additional birth was associated with an overall 6% reduction in ovarian cancer risk. Moreover, similarly to the present study in the study by Wentzensen et al. [1] the largest reduction in risk was observed in clear-cell tumors.
Response to systemic therapy in locally advanced and metastatic renal cell carcinoma: can it be predicted?
Published in Expert Review of Anticancer Therapy, 2021
Javier González, Jeffrey J Gaynor, Gaetano Ciancio
The most studied immunohistochemical biomarker PD-1 L failed to demonstrate a predictive capacity in mRCC. Although it seems to confer poor prognosis both in the clear cell and non-clear cell subsets, its ability to correctly identify responders and non-responders to treatment is debatable. Tumor heterogeneity, a wide range of cutoff values, and differences in expression between primary and metastatic sites are its major drawbacks for use. Different immunohistochemical predictor identifications (through better characterization of immune cells and their phenotype) would represent a new step forward in this field. In fact, the use of transcriptomic analysis in the identification of responders to treatment is currently the area of most intensive research. Gene expression profiling for both involved cells and microenvironment, specific RNA signatures identification, and whole-exome sequencing to identify mutations that lead to the loss of different cellular functions are still under evaluation.