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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
In adults, renal cancer is known as renal carcinoma, renal cell carcinoma or hypernephroma. It spreads locally or via the lymphatic system to the renal hilum, retroperitoneum and para-aortic lymph nodes and often invades the renal veins and inferior vena cava. The left testicular vein drains into the left renal vein, so blockage of this vein by tumour can cause a left-sided varicocoele (dilated varicose vessels in the scrotum). Metastases typically arise in the lungs, liver, bones and brain.
Renal Cell Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
The prognosis and rate of progression of renal cancer can vary widely in patients with metastatic disease. For selected patients, a period of observation before starting chronic long-term therapy may be considered. Patients with low-volume, non-threatening metastatic disease (often lung only) are often considered for this approach and considerable intervals may elapse before any systemic treatment is required. A recent prospective phase II trial looked at active surveillance. Forty-eight asymptomatic patients with low tumor burden were included; all but one were good or intermediate IDMC risk, with prior nephrectomy. Median time to initiation of systemic treatment was 14.9 months (95%CI 10.6–25).44 The trial did not include an immediate treatment arm for comparison, so whether delayed initiation affects disease outcome is unknown.
Cancer
Published in Spyridon E. Kintzios, Maria G. Barberaki, Evangelia A. Flampouri, Plants That Fight Cancer, 2019
Kidney (renal) cancer is associated with heredity, sex (males), smoking, and obesity. Wilms tumor refers to renal cancer in children under four years of age. If treated at an early stage, survival rate may exceed 75–80%, a considerable increase over the last years.
Cancer symptom response as an oncology clinical trial end point
Published in Expert Review of Quality of Life in Cancer Care, 2018
Laura C. Bouchard, Neil Aaronson, Kathleen Gondek, David Cella
Cella and colleagues [51] used a combined analytic approach including change from baseline and ID-based end points to compare the impact of nivolumab vs. everolimus on the quality of life of patients with advanced renal cell carcinoma in a phase III trial. Disease-specific symptoms in renal cancer were assessed with the FACT-Kidney Symptom Index-Disease Related Symptoms (FKSI-DRS) [52]. In this study, the ID criteria for the FKSI-DRS was pre-set as a 2-point difference from baseline. In addition, overall quality of life was assessed with the EQ-5D questionnaires [45]. Findings revealed more patients with clinically meaningful improvements in disease-specific symptoms since baseline in the group receiving treatment with nivolumab [51].
A real-world pharmacovigilance study of axitinib: data mining of the public version of FDA adverse event reporting system
Published in Expert Opinion on Drug Safety, 2022
Yamin Shu, Yufeng Ding, Bing Dai, Qilin Zhang
During the study period, 10,703,806 reports were collected from the FAERS database. There were 9044 case reports of axitinib as the PS after the exclusion of duplicates, and 24,952 AEs were found to be related to axitinib. Moreover, the proportion of PS, SS, C, and I is 9044: 2714: 421: 25. The clinical characteristics of events with axitinib are described in Table 1. Among all AEs, males (52.02%) accounted for a larger proportion than females (21.04%). In terms of age composition, the elderly individuals (aged >65 years) accounted for the higher proportion with 42.11% (n = 3808). Renal cancer was the most reported indication (29.11%), followed by renal cell carcinoma (16.20%) and metastatic renal cell carcinoma (11.90%). Most reports were submitted by health-care professionals, including physician (27.55%), pharmacist (12.33%), and other health-professionals (24.93%). Interestingly, consumers represented the main source of reports accounting for 32.40%. The country that reported the most was America (64.39%), followed by Japan (9.63%), Argentina (5.30%), Canada (2.83%), and France (1.97%). In addition to other serious medical events (25.80%), hospitalization (24.71%) was the most frequently reported serious outcome. Death or life-threatening events were reported in 2138 (23.64%) and 197 (2.18%) cases, respectively. The high percentage of death or life-threatening events might be more related to disease progression of tumor. In terms of reporting years, with the exception of 7.11% reported in the first quarter of 2021, the most reported year was 2020 (21.76%), followed by 2015 (11.39%), 2014 (11.39%), 2019 (10.80%), and 2013 (10.54%), respectively.
Burden of renal cancer in Nordic countries
Published in Scandinavian Journal of Urology, 2019
Sara Haunstrup Næraa, Ann Buhl Bersang, Claus Dahl, Yousif Subhi, Nessn Azawi
The first important aspect to discuss is how to prevent individuals from getting renal cancer. Ageing is inevitable, but lifestyle factors can be changed. Capitanio et al. [2] recently systematically reviewed risk factors of renal cancer and identified the following strong lifestyle risk factors for renal cancer: obesity (increases risk), physical activity (decreases risk), smoking (increases risk). However, it should be noted that all studies were observational and to date no interventional studies have looked at the effect of lifestyle intervention on the incidence of renal cancer [2]. To highlight the potential impact in Nordic countries, we took Denmark as an example and summarized risk factors and their effect sizes and potential impact based on a recent population-based lifestyle questionnaire (Table 3) [2,8–11]. Briefly; 10–20% of the adult population in Denmark have a body mass index of ≥30, and 56% of them state that they want to lose weight; 20–40% of the adult population in Denmark are not physically active according to minimum recommendations from WHO, and 71% of them state that they want to be more physically active; 10–30% of the adult population in Denmark are smokers and 73% of them state that they want to quit smoking [8]. Effective initiatives at the population level are important: an annual decrease in age-specific incidence rates of just 1% can have a significant impact, as illustrated in the sensitivity analyses. Naturally, the importance of addressing these lifestyle factors go beyond only prevention of renal cancer and have important political and societal attention in all Nordic countries. Addressing lifestyle factors in the general population should be a priority to avoid a high-cost cancer such as renal cancer.