Comparative assessment of Brassica cultivars for genotypic variability in phytoremediation of soil exposed to lead (Pb) contamination.

The soil pollution caused with accretion of pollutant elements like lead (Pb) is the major environmental concern nowadays. Phytoremediation of contaminated soils using Brassica cultivars that act as hyperaccumulator plants for Pb emerges as an important technique for decontamination of Pb spiked soils. Therefore, pot study was carried out to compare the efficiency of three Brassica cultivars and select the most efficient cultivar for phytoremediation of Pb spiked soils. The experimental soil was contaminated with Pb applied @ 0, 125, 250, 500, 750, and 1,000 mg kg-1 soil. Our outcomes reflected that increased rates of Pb pollution in soil from 125 to 1,000 mg kg-1 soil resulted in decline of yield but enhanced the Pb acquisition of all Brassica cultivars. Comparison of cultivars indicated the highest biomass production (16.7 g pot-1), Pb acquisition (4,011.7 µg pot-1), contamination indices i.e., tolerance index (70.6), and bioaccumulation coefficient (17.03) by Brassica juncea produced thereby proving it as the most efficient cultivar for phytoremediation of Pb spiked soil.

Consumption of crops raised in Pb spiked soil resulted in impaired health of human beings through its entrance into the food chain. Choice of techniques for decontamination of Pb polluted soils poses a great challenge worldwide. Among different techniques phytoremediation i.e., use of hyper accumulator crops is the most economical and ecological approach for the decontamination of Pb spiked soils. Therefore, this study was conducted for evaluating the comparative efficacy of three Brassica cultivars for their Pb accumulation potential and pollution indices and select the most efficient cultivar for phytoremediation of Pb spiked soils.

Role of Embolic Protection in Percutaneous Coronary Intervention without Saphenous Venous graft lesions in ST-elevation myocardial infarction - a systematic review and meta-analysis.

INTRODUCTION: Embolic protection devices are catheter-based devices that can be used to capture atherosclerotic remnants released during percutaneous coronary intervention (PCI). We aim to study the efficacy and safety of EPDs in PCIs without saphenous vein grafts (SVG) in ST-elevation myocardial infarction(STEMI). METHODS: 3 electronic databases of MEDLINE, Web of Science, and Embase were searched from inception to Apr 10, 2024, to identify relevant randomized controlled trials (RCTs) that compared outcomes of patients subjected to EPD during PCI with control group where EPDs were not utilized. The primary outcome was 30-day all-cause mortality. Secondary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE) at 30 days, post-PCI Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow attainment, ST-segment resolution at 90 minutes post-procedure and post-procedure angiographically detectable signs of distal embolization. The effect estimates of outcomes were assessed using risk ratio (RR) with a 95% confidence interval (CI). Random-effects meta-analysis was conducted using the restricted maximum likelihood method given the inter-study variance was inevitable. RESULTS: We included 3 RCTs enrolling 741 patients (age 61.6 ± 12.15 years, 22% females) undergoing PCI without SVG lesions. As opposed to the control group, the use of EPD did not yield a significant effect on all-cause mortality (RR, 0.76; 95% CI, 0.31-1.86; I2 = 0%), MACCE (RR, 0.66; 95% CI, 0.34-1.27; I2 = 0%), post-PCI TIMI 3 flow (RR, 1.18; 95% CI, 0.86-1.62; I2 = 77%) and ST segment resolution at 90 minutes post-procedure (RR, 1.05; 95% CI, 0.90-1.22; I2 = 0%). However, EPD significantly decreased angiographically detectable signs of distal embolization (RR, 0.60; 95% CI, 0.36 to 0.99; I2 = 0%). CONCLUSIONS: EPD significantly reduced angiographically detectable signs of distal embolization in PCI without SVG lesions in STEMI, though there were no clinical signs of improved flow or mortality. Further trials are necessary to thoroughly evaluate the potential benefits and requirements of EPD usage in such procedures.

Impact of heavy metals, oxidative stress, expression of VHL, and antioxidant genes in the pathogenesis of renal cell carcinoma.

INTRODUCTION: Heavy metals exposure is a known carcinogen in humans. The impact of heavy metals in the pathogenesis of renal cell carcinoma (RCC) is unclear with scant available literature. Though previous studies have evaluated the role of heavy metals in RCC, majority of those studies have evaluated either single or few heavy metals in urine. None of the prior studies have evaluated an extensive panel of heavy metals in blood, urine, and tissue in the same patient along with the serum oxidation status and gene expression to establish a cause-and-effect relationship. This study aims to evaluate the role of extensive panel of heavy metals, oxidative status, and gene expression in RCC. METHODOLOGY: This observational study recruited RCC patients who visited our tertiary care centre from 2019 to 2023. Age matched healthy volunteers were included as controls. Blood, urine, and tissue samples (tumor and adjacent normal tissue) were collected from RCC patients. Levels of arsenic, copper, manganese, selenium, cadmium, lead, and mercury were measured in each of the samples. Serum oxidative stress markers like glutathione peroxidase (GPX), lipid peroxidase (LPO), and superoxide dismutase (SOD) were measured. Genetic expression of Von Hippel-Lindau (VHL), catalase (CAT), superoxide dismutase (SOD1), and glutathione peroxidase (GPX1) genes were measured in the tumor tissue and adjacent normal parenchyma. RESULTS: 150 cases and 150 age matched controls were enrolled. RCC cases had elevated blood levels of arsenic (P = 0.02), copper (P = 0.01), manganese (P < 0.001), cadmium (P < 0.001), lead (P < 0.001), and mercury (P = 0.02) compared to controls. Urine levels of selenium (P = 0.02), mercury (P = 0.03), and lead (P = 0.04) were higher in cases. Reduced levels of serum GPx (P = 0.02) and higher levels of LPO (P = 0.04) were detected in cases. Elevated levels of copper (P = 0.03), manganese (P = 0.002), selenium (P < 0.001), and cadmium (P < 0.001) were found in the adjacent normal parenchyma compared to the tumor tissue. VHL (P = 0.03) and oxidative stress gene expressions were lower in the tumour tissue compared to the normal parenchyma. CONCLUSION: Elevated levels of heavy metals in the blood, urine, tissue, and imbalance in the serum oxidative status along with downregulated tumor suppressor VHL and oxidative stress genes in the tumor tissues likely explain the carcinogenic role of heavy metals in RCC. Environmental exposure is the main cause of heavy metal toxicity. Mitigating the environmental exposure of heavy metals and thereby their toxicity might play a role in cancer prevention.

Multimodality imaging of urinary tract tuberculosis.

Imaging is a key component of diagnosis and treatment response evaluation of urinary tract tuberculosis (UT TB). Tuberculosis can have a long latency, but if found early, one may have the opportunity to prevent complications such as ureteral strictures, obstructive nephropathy, contracted (thimble) bladder, renal parenchymal destruction/calcification, and renal failure. Imaging can aid in diagnosis and differential diagnoses, evaluate the extent of disease and complications, and guide image-directed biopsy, surgical planning, and evaluation of treatment response. Imaging abnormalities in the renal parenchyma and urinary tract at different stages of the disease, lymphadenopathy, and extra-urinary tract organ involvement are suggestive of UT TB. Recent advances in imaging modalities aid in UT TB diagnosis, follow-up, and guiding treatment.

Correction: Alhuarrat et al. Comparison of In-Hospital Outcomes between Early and Late Catheter-Directed Thrombolysis in Acute Pulmonary Embolism: A Retrospective Observational Study. J. Clin. Med. 2024, 13, 1093.

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Ionic reverberation modulates the cellular fate of CD8+tissue resident memory T cells (TRMs) in patients with renal cell carcinoma: A novel mechanism.

In metastatic renal cell carcinoma (mRCC), existing treatments including checkpoint inhibitors are failed to cure and/or prevent recurrence of the disease. Therefore, in-depth understanding of tumor tissue resident memory T cells (TRMs) dysfunction are necessitated to enrich efficacy of immunotherapies and increasing disease free survival in treated patients. In patients, we observed dysregulation of K+, Ca2+, Na2+ and Zn2+ ion channels leads to excess infiltration of their respective ions in tumor TRMs, thus ionic gradients are disturbed and cells became hyperpolarized. Moreover, overloaded intramitochondrial calcium caused mitochondrial depolarization and trigger apoptosis of tumor TRMs. Decreased prevalence of activated tumor TRMs reflected our observations. Furthermore, disruptions in ionic concentrations impaired the functional activities and/or suppressed anti-tumor action of circulating and tumor TRMs in RCC. Collectively, these findings revealed novel mechanism behind dysfunctionality of tumor TRMs. Implicating enrichment of activated TRMs within tumor would be beneficial for better management of RCC patients.

Clinical significance of blocking novel immune checkpoint B7-H4 in urothelial carcinoma of bladder as a potential therapeutic target.

Urothelial Carcinoma of Bladder is complex disease with high mortality and recurrence rates. Current standard regimes have exhibited anti-tumor activity but still, a proportion of patients are non-responsive or in-eligible to receive such treatments. Immune checkpoints have emerged as potential class of therapeutics to be tested in UCB patients. Clinical trials targeting PD-1/PD-L1 axis have been tested in UCB but still a proportion of patients are non-responsive to it which stresses upon identifying new targets. New immune checkpoint B7-H4 has been shown to negatively regulate T cell activity in cancer and is a poor prognostic factor in various solid tumors. In this study we assessed the novel immune checkpoint B7-H4 status in UCB patients. We observed elevated expression of B7-H4 and PD-L1 on CD8+ T cells in circulation of UCB patients. Relative mRNA expression and immunohistochemistry displayed upregulation in bladder tumor tissue. Increased expression of B7-H4 along with PD-L1 in periphery and tumor of UCB patients highlights involvement of B7-H4 in disease progression. Combinatorial blocking of B7-H4 and PD-L1 enhanced IFN-γ and granzyme B in CD8+ T cells functional T cell immune response in UCB patients. Also, B7-H4 was significantly associated with clinico-pathological parameters. Our findings highlight B7-H4 as potential therapeutic target for treatment of UCB patients in future after further validation.

Comparison of In-Hospital Outcomes between Early and Late Catheter-Directed Thrombolysis in Acute Pulmonary Embolism: A Retrospective Observational Study.

The purpose of this study is to evaluate whether early initiation of catheter-directed thrombolysis (CDT) in patients presenting with acute pulmonary embolism is associated with improved in-hospital outcomes. A retrospective cohort was extracted from the 2016-2019 National Inpatient Sample database, consisting of 21,730 weighted admissions undergoing CDT acute PE. From the time of admission, the sample was divided into early (<48 h) and late interventions (>48 h). Outcomes were measured using regression analysis and propensity score matching. No significant differences in mortality, cardiac arrest, cardiogenic shock, or intracranial hemorrhage (p > 0.05) were found between the early and late CDT groups. Late CDT patients had a higher likelihood of receiving systemic thrombolysis (3.21 [2.18-4.74], p < 0.01), blood transfusion (1.84 [1.41-2.40], p < 0.01), intubation (1.33 [1.05-1.70], p = 0.02), discharge disposition to care facilities (1.32 [1.14-1.53], p < 0.01). and having acute kidney injury (1.42 [1.25-1.61], p < 0.01). Predictors of late intervention were older age, female sex, non-white ethnicity, non-teaching hospital admission, hospitals with higher bed sizes, and weekend admission (p < 0.01). This study represents a comprehensive evaluation of outcomes associated with the time interval for initiating CDT, revealing reduced morbidity with early intervention. Additionally, it identifies predictors associated with delayed CDT initiation. The broader ramifications of these findings, particularly in relation to hospital resource utilization and health disparities, warrant further exploration.

Management conundrum in a case of renal cell cancer (RCC) on dual antiplatelet therapy (DAPT) for recently placed coronary drug-eluting stent (DES).

A man in his 50s presented in an emergency with breathlessness and chest discomfort. On evaluation, he was diagnosed with coronary artery disease, with more than 80% narrowing of the right coronary and left circumflex arteries. The patient underwent percutaneous coronary intervention and was started on dual antiplatelet (DAPT) therapy. After starting DAPT, the patient developed gross haematuria with a drop in haematocrit. Further evaluation revealed a left renal mass with urinary bladder clots. Because of the risk of stent thrombosis on stopping DAPT, radical nephrectomy was deferred, and the patient underwent left renal artery angioembolisation and bladder clot evacuation. On the follow-up, the patient was stable with a gradual decrease in renal mass size, and after a year, the patient underwent definitive surgery. The patient is doing well in 4 years of follow-up with no metastasis.

Serum prostate-specific antigen trends and prostate cancer detection on follow-up in men with a prior negative biopsy: A cohort study.

Introduction: Elevated serum prostate-specific antigen (PSA) is the most common trigger for a prostate biopsy. However, the range of normal PSA is poorly defined in many populations. Men with "elevated" PSA may not harbor cancer, and it is unclear if such men with a prior negative prostate biopsy should be biopsied again. We conducted a cohort study to assess the PSA trends and cancer detection rates in such men. Methods: In an Institutional Review Board-approved ambispective study, men who underwent prostate biopsy between January 2016 and December 2021 for PSA > 4 ng/mL were identified. Among them, those whose biopsy was negative for malignancy were contacted either telephonically or reviewed in person, and the most recent PSA and histopathology of any repeat prostate biopsy were determined. These were evaluated to assess the PSA trend, re-biopsy rate, and cancer detection rate. Results: During the study period, prostate biopsies were performed in a total of 1260 men; out of which 444 were negative for malignancy and 241 patients fulfilled the inclusion criteria. Their median prebiopsy PSA was 9.81 ng/mL (interquartile range [IQR]: 7.14-15.6), and the median follow-up PSA was 5.08 (IQR: 3.18-8.4). At a median follow-up of 53 months (range: 6-77 months), PSA had decreased in 177 (73.4%) patients, was static in 48 (19.9%) patients, and increased in only 16 (6.6%) patients. Repeat biopsy was performed on 20 patients; of whom seven had cancer (35%) with an overall positivity rate of 2.9% among the 241 patients. Although the positivity rate was higher in men with increased PSA, it was not statistically different from those with lower or similar PSA. No factors could be identified to predict a positive repeat biopsy. Conclusions: PSA, the sole trigger for a prostate biopsy, declined in nearly three-quarters of men with a negative first biopsy, and <3% of men were detected to have cancer on a repeat biopsy. This information could help appropriately counsel patients and allay anxiety after a negative biopsy.

Material matters: exploring the interplay between natural biomaterials and host immune system.

Biomaterials are widely used for various medical purposes, for instance, implants, tissue engineering, medical devices, and drug delivery systems. Natural biomaterials can be obtained from proteins, carbohydrates, and cell-specific sources. However, when these biomaterials are introduced into the body, they trigger an immune response which may lead to rejection and failure of the implanted device or tissue. The immune system recognizes natural biomaterials as foreign substances and triggers the activation of several immune cells, for instance, macrophages, dendritic cells, and T cells. These cells release pro-inflammatory cytokines and chemokines, which recruit other immune cells to the implantation site. The activation of the immune system can lead to an inflammatory response, which can be beneficial or detrimental, depending on the type of natural biomaterial and the extent of the immune response. These biomaterials can also influence the immune response by modulating the behavior of immune cells. For example, biomaterials with specific surface properties, such as charge and hydrophobicity, can affect the activation and differentiation of immune cells. Additionally, biomaterials can be engineered to release immunomodulatory factors, such as anti-inflammatory cytokines, to promote a tolerogenic immune response. In conclusion, the interaction between biomaterials and the body's immune system is an intricate procedure with potential consequences for the effectiveness of therapeutics and medical devices. A better understanding of this interplay can help to design biomaterials that promote favorable immune responses and minimize adverse reactions.

Institute for Clinical and Economic Review - Peterson Health Technology Institute value assessment framework for digital health technologies.

Digital health technologies (DHTs) are a broad and rapidly innovating class of interventions with distinctive pathways for development, regulatory approval, uptake and reimbursement. Given the unique nature of DHTs, existing value assessment frameworks and evidence standards for health technologies such as drugs and devices are not directly applicable. The value assessment framework presented here describes a conceptual model and associated methods to guide assessments of DHTs. The framework seeks to accomplish two goals: to set evidence standards that guide technology developers to generate robust evidence on their products; and to provide reviews that help organizations adopt high-impact DHTs with the strongest evidence for delivering improved clinical outcomes and cost savings. This assessment framework will serve as the roadmap for future evaluations of DHTs by the Institute for Clinical and Economic Review (ICER) and the Peterson Health Technology Institute (PHTI). We believe that all stakeholders will benefit from comprehensive and explicit standards of evidence on the different dimensions necessary to understand the value of DHTs.

Impact of manures and fertilizers on yield and soil properties in a rice-wheat cropping system.

The use of chemical fertilizers under a rice-wheat cropping system (RWCS) has led to the emergence of micronutrient deficiency and decreased crop productivity. Thus, the experiment was conducted with the aim that the use of organic amendments would sustain productivity and improve the soil nutrient status under RWCS. A three-year experiment was conducted with different organic manures i.e. no manure (M0), farmyard manure @ 15 t ha-1 (M1), poultry manure @ 6 t ha-1(M2), press mud @ 15 t ha-1(M3), rice straw compost @ 6 t ha-1(M4) along with different levels of the recommended dose of fertilizer (RDF) i.e. 0% (F1), 75% (F2 and 100% (F3 in a split-plot design with three replications and plot size of 6 m x 1.2 m. Laboratory-based analysis of different soil as well as plant parameters was done using standard methodologies. The use of manures considerably improved the crop yield, macronutrients viz. nitrogen, phosphorus, potassium and micronutrients such as zinc, iron, manganese and copper, uptake in both the crops because of nutrient release from decomposed organic matter. Additionally, the increase in fertilizer dose increased these parameters. The system productivity was maximum recorded under F3M1 (13,052 kg ha-1) and results were statistically identical with F3M2 and F3M3. The significant upsurge of macro and micro-nutrients in soil and its correlation with yield outcomes was also observed through the combined use of manures as well as fertilizers. This study concluded that the use of 100% RDF integrated with organic manures, particularly farmyard manure would be a beneficial resource for increased crop yield, soil nutrient status and system productivity in RWCS in different regions of India.

Association of heavy metals and trace elements in carcinoma urinary bladder: A case-controlled study.

Introduction: Abnormal levels of heavy metals (HM) and trace elements (TE) affect body metabolism and can induce carcinogenesis. This study aims to evaluate the role of HM and TE in carcinoma urinary bladder (CAUB). Methods: Patients with biopsy-proven CAUB (n = 100) were taken as the study group, while age-and sex-matched healthy volunteers were taken as control (n = 100). Blood and urine samples were compared for Arsenic (As), Copper (Cu), Manganese (Mn), Selenium (Se), Cadmium (Cd), Lead (Pb), and Mercury (Hg) levels. Serum glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and lipid peroxidation (LPO) levels were assessed to know the redox status between the two groups. Results: A significantly higher blood level of As, Mn, and Pb was observed in CAUB cases as compared to controls. Blood Se level was significantly lower in CAUB patients. On comparing urinary levels, CAUB patients had a higher As, Mn, and Pb levels compared to controls. Further, 68% and 59% of patients had their blood and urinary HM and TE levels above the permitted level, respectively. CAUB cases also had a lower GSH-Px (113.5 ± 44.7 vs. 163.9 ± 120.5, P = 0.0002), lower SOD levels (11.35 ± 5.6 vs. 13.75 ± 3.9, P = 0.008), and a higher LPO levels (15.5 ± 14.7 vs. 11.18 ± 11.2, P = 0.02) in the serum. Conclusions: A significantly higher concentration of As, Mn, and Pb was noted in the blood and urine of CAUB patients compared to controls. CAUB cases also had lower serum GSH-Px and SOD levels with a concomitant increased serum LPO assay suggesting underlying oxidative stress.

Quality of life assessment in testicular non-seminomatous germ cell tumour survivors.

PURPOSE: Patients with Germ cell tumours (GCT) are at risk of long-term toxicities due to multimodality therapy. It is debatable whether there is an impact on the quality of life(QoL) of GCT survivors. METHODS: A case-control study was conducted at a tertiary care centre in India, using the EORTC QLQ C30 questionnaire, to compare the QoL between GCT survivors(disease free > 2 years) and healthy matched controls. A multivariate regression model was used to identify factors affecting QoL. RESULTS: A total of 55 cases and 100 controls were recruited. Cases had a median age of 32 years (interquartile range, IQR 28-40 years), ECOG PS of 0-1(75%), advanced stage III (58%), chemotherapy (94%) and 66% were > 5 years from diagnosis. The median age of controls: 35 years (IQR 28-43 years). A statistically significant difference was seen for emotional (85.8 ± 14.2 vs 91.7 ± 10.4, p 0.005), social(83.0 ± 22.0 vs 95.2 ± 9.6, p < 0.001) and global scales (80.4 ± 21.1 vs 91.3 ± 9.7, p < 0.001). Cases had more nausea and vomiting(3.3 ± 7.4 vs 1.0 ± 3.9, p 0.015), pain(13.9 ± 13.9 vs 4.8 ± 9.8, p < 0.001), dyspnea(7.9 + 14.3 vs 2.7 ± 9.1, p 0.007), and appetite loss(6.7 ± 14.9 vs 1.9 ± 7.9, p 0.016) and greater financial toxicity(31.5 ± 32.3 vs 9.0 ± 16.3, p < 0.001). Adjusting for age, performance status, BMI, stage, chemotherapy, RPLND, recurrent disease, and time since diagnosis, no predictive variables were significant. CONCLUSION: There is a detrimental impact of history of GCT in long term survivors of GCT.

Minerals and chelated-based manganese fertilization influences the productivity, uptake, and mobilization of manganese in wheat (Triticum aestivum L.) in sandy loam soils.

Manganese (Mn) is an essential micronutrient in plants, and it is necessary for hydrolysis in photosystem II, chlorophyll biosynthesis, and also chloroplast breakdown. Limited Mn availability in light soil resulted in interveinal chlorosis, poor root development, and the development of fewer tillers, particularly staple cereals including wheat, while foliar Mn fertilizers were found efficient in improving crop yield as well as Mn use efficiency. In the above context, a study was conducted in consecutive two wheat growing seasons for screening of the most effective and economical Mn treatment for improving the yield and Mn uptake in wheat and to compare the relative effectiveness of MnCO3 against the recommended dose of MnSO4 for wheat. To fulfill the aims of the study, three manganese products, namely, 1) manganese carbonate MnCO3 (26% Mn w/w and 3.3% N w/w), 2) 0.5% MnSO4·H2O (30.5% Mn), and 3) Mn-EDTA solution (12% Mn), were used as experimental treatments. Treatments and their combinations were as follows: two levels of MnCO3 (26% Mn) @ 750 and 1,250 ml ha-1 were applied at the two stages (i.e., 25-30 and 35-40 days after sowing) of wheat, and three sprays each of 0.5% MnSO4 (30.5% Mn) and Mn-EDTA (12% Mn) solution were applied in other plots. The 2-year study showed that Mn application significantly increased the plant height, productive tillers plant-1, and 1,000 grain weight irrespective of fertilizer source. The results of MnSO4 for grain yield wheat as well as uptake of Mn were statistically at par with both levels (750 and 1,250 ml ha-1) of MnCO3 with two sprays at two stages of wheat. However, the application of Mn in the form of 0.5% MnSO4·H2O (30.5% Mn) was found more economical than MnCO3, while the mobilization efficiency index (1.56) was found maximum when Mn was applied in MnCO3 with two sprays (750 and 1,250 ml ha-1) in the two stages of wheat. Thus, the present study revealed that MnCO3 can be used as an alternative to MnSO4 to enhance the yield and Mn uptake of wheat.

Disruption in networking of KCMF1 linked ubiquitin ligase impairs autophagy in CD8+ memory T cells of patients with renal cell carcinoma.

Metastatic Renal Cell Carcinoma (mRCC) remains incurable, despite the current checkpoint-blockade-driven, limited overall response rate. The CD8+ memory T cells can mount a rapid and an effective response. The ubiquitin ligase RAD6-KCMF1-UBR4-mediated regulation of autophagy in CD8+ memory T cells in patients with renal cell carcinoma (RCC) remains unexplored. Consequently, flow cytometry was used to study memory T cells, and their subsets, including activation and regulatory phenotypes in peripheral blood mononuclear cells (PBMCs). Expression of the ubiquitin ligase and autophagy was measured both at the cellular and molecular levels in memory T cells of patients with RCC. JC.1 staining and Annexin/PI assays were used to evaluate the memory T cells depolarization and apoptosis rates. The results indicated that the disruption of Ub-E2-E3 complex and impaired autophagy in memory T cells diminished their ability to survive and combat against tumor cells. Inhibition of memory T cells apoptosis by targeting E3 ubiquitin ligase or autophagy pathways can be explored as a potential therapeutic strategy to improve the long-term survival of memory T cells in RCC.

A Large Contemporary Experience of Renal Tumors in Young: Clinico-pathological Profile and Long-Term Survival Patterns.

Renal tumors in young population are relatively rare. We reviewed our experience with renal masses in patients below 45 years of age. Our objective was to analyze clinico-pathological and survival characteristics of renal malignancy in young adults in contemporary era. The medical records of patients below 45 years of age who underwent surgery for renal mass at our tertiary care center between 2009 and 2019 were retrospectively analyzed. Pertinent clinical information was compiled, including age, gender, year and type of surgery, histopathology and survival data. A total of 194 patients who underwent nephrectomy for suspicious renal masses were included. Mean age was 35.5 (14-45) years and males were 125 (64.4%). A total of 29/198 (14.6%) specimens had benign disease. In addition, 155 (91.7%) out of 169 malignant tumors were renal cell carcinomas, clear cell variant being the most common type (51%). Compared to RCC, non-RCC tumors were more common in females (27.7 vs 78.6%, p < 0.0001), had an early age of diagnosis (27.2 vs 36.9 year, p < 0.00001) and poorer progression-free (58.3 vs 72.0%, p = 0.03) and overall survival (63.6 vs 84.2%, p = 0.02) at 6 years of follow-up. Renal masses in young adults are most commonly RCC but can also include other diverse types. RCC in young adults is usually organ confined and has good prognosis. As compared to RCC, non-RCC malignant tumors occur in young age, are more in females, and have worse prognosis. Supplementary Information: The online version contains supplementary material available at 10.1007/s13193-022-01643-2.