[Expression of Hemeoxygenase-1 and clear cell renal cell carcinoma aggressiveness.] / Expresión de Hemo Oxigenasa-1 y agresividad del carcinoma renal de células claras.

OBJECTIVE: Hemoxigenase 1 (HO-1) is an enzyme that has anti-apoptotic and proliferative effects on tumor cells. However, there is little epidemiological and clinical evidence on the role of HO-1 in urologic tumors. OBJECTIVE: To determine if there is correlation between the expression of HO-1 and the histological characteristics, evolution, Disease Free Survival (DFS) and cancer mortality in Clear Cell Renal Cell Carcinoma (cRCC). MATERIALS AND METHODS: A retrospective study including 34 patients (9 women and 25 men) with cRCC from the "Servicio de Urología del Policlínico Neuquén" (Argentina) throughout 2003-2008. The expression of HO-1 by Immunohistochemistry (IHC) was determined. The statistical analysis was performed using the Student'sT test and Pearson correlation coefficient (p≤0.05). RESULTS: HO-1 was expressed in the epithelial cells of the tubules from normal kidney tissue and in the cytoplasmof cRCC tumor cells. There were no differences in the HO-1 expression related to the gender, age, tumorsize, stage of disease and 5 years DFS. High FuhrmancRCC had a greater expression of HO-1 compared with low Fuhrman cRCC (p≤0.05). The score of immunostaining for HO-1 was greater in those tumors located in the mesorrenal area, which coincidentally presented a more advanced stage of the disease. CONCLUSIONS: Over expression of HO-1 in tumors located in the interpolar zone and with high Furhman grade suggest that HO-1 could be a good adjunctive marker for the aggressiveness of the cRCC.

OBJETIVO: Hemoxigenasa 1 (HO-1) es una enzima que tiene efectos antiapoptóticos y proliferativos en células tumorales. Sin embargo, existe poca evidencia epidemiológica y clínica sobre el rol de la HO-1 en los tumores urológicos. Objetivo: determinar si existe correlación entre la expresión de HO-1 y las características histológicas, evolución, Sobrevida Libre de Enfermedad (SLE) y mortalidad por cáncer en Carcinomas Renales de Células Claras (cRCC). MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo en 34 pacientes (9 mujeres y 25 hombres) con cRCC del Servicio de Urología del Policlínico Neuquén, reclutados entre los años 2003 y 2008. Se determinó la expresión de HO-1 por Inmunohistoquímica (IHQ). El análisis estadístico se realizó mediante la prueba T de Student y Coeficiente de correlación de Pearson (p<0,05). RESULTADOS: HO-1 se expresó en el epitelio de los túbulos del tejido renal normal y en el citoplasma de las células tumorales de cRCC. No se observaron diferencias en la expresión de HO-1 según género, edad, tamaño tumoral, estadio de la enfermedad y SLE a los 5 años. Los tumores con Fuhrman alto presentaron una mayor expresión de HO-1 que los Furhman bajo (p≤0,05). El score de inmunotinción de HO-1 fue mayor en los tumores localizados en la zona interpolar, que coincidentemente presentaban un estadio más avanzado de la enfermedad. CONCLUSIONES: La sobreexpresión de HO-1 en tumores localizados en la zona interpolar y con grado de Furhman alto sugieren que HO-1 podría ser un buen marcador complementario de la agresividad del cRCC.

Expresión de Hemo Oxigenasa-1 y agresividad del carcinoma renal de células claras / Expression of Hemeoxygenase-1 and clear cell renal cell carcinoma aggressiveness

OBJETIVO: Hemoxigenasa 1 (HO-1) es una enzima que tiene efectos antiapoptóticos y proliferativos en células tumorales. Sin embargo, existe poca evidencia epidemiológica y clínica sobre el rol de la HO-1 en los tumores urológicos. OBJETIVO: determinar si existe correlación entre la expresión de HO-1 y las características histológicas, evolución, Sobrevida Libre de Enfermedad (SLE) y mortalidad por cáncer en Carcinomas Renales de Células Claras (cRCC). MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo en 34 pacientes (9 mujeres y 25 hombres) con cRCC del Servicio de Urología del Policlínico Neuquén, reclutados entre los años 2003 y 2008. Se determinó la expresión de HO-1 por Inmunohistoquímica (IHQ). El análisis estadístico se realizó mediante la prueba T de Student y Coeficiente de correlación de Pearson (p < 0,05). RESULTADOS: HO-1 se expresó en el epitelio de los túbulos del tejido renal normal y en el citoplasma de las células tumorales de cRCC. No se observaron diferencias en la expresión de HO-1 según género, edad, tamaño tumoral, estadio de la enfermedad y SLE a los 5 años. Los tumores con Fuhrman alto presentaron una mayor expresión de HO-1 que los Furhman bajo (p≤0,05). El score de inmunotinción de HO-1 fue mayor en los tumores localizados en la zona interpolar, que coincidentemente presentaban un estadio más avanzado de la enfermedad. CONCLUSIONES: La sobreexpresión de HO-1 en tumores localizados en la zona interpolar y con grado de Furhman alto sugieren que HO-1 podría ser un buen marcador complementario de la agresividad del cRCC

OBJECTIVE: Hemoxigenase 1 (HO-1) is an enzyme that has anti-apoptotic and proliferative effects on tumor cells. However, there is little epidemiological and clinical evidence on the role of HO-1 in urologic tumors. OBJECTIVE: To determine if there is correlation between the expression of HO-1 and the histological characteristics, evolution, Disease Free Survival (DFS) and cancer mortality in Clear Cell Renal Cell Carcinoma (cRCC). MATERIALS AND METHODS: A retrospective study including 34 patients (9 women and 25 men) with cRCC from the "Servicio de Urología del Policlínico Neuquén" (Argentina) throughout 2003-2008. The expression of HO-1 by immunohistochemistry (IHC) was determined. The statistical analysis was performed using the Student's T test and Pearson correlation coefficient (p≤0.05). RESULTS: HO-1 was expressed in the epithelial cells of the tubules from normal kidney tissue and in the cytoplasm of cRCC tumor cells. There were no differences in the HO-1 expression related to the gender, age, tumor size, stage of disease and 5 years DFS. High Fuhrman cRCC had a greater expression of HO-1 compared with low Fuhrman cRCC (p≤0.05). The score of immunostaining for HO-1 was greater in those tumors located in the mesorrenal area, which coincidentally presented a more advanced stage of the disease. CONCLUSIONS: Overexpression of HO-1 in tumors located in the interpolar zone and with high Furhman grade suggest that HO-1 could be a good adjunctive marker for the aggressiveness of the cRCC

Characteristics and Surgical Outcomes in Very Elderly Patients (≥75 years) with Renal Cell Carcinoma: Data from the Latin American Renal Cancer Group.

BACKGROUND: The incidence of renal cell carcinoma (RCC) is increasing globally due to an aging population and widespread use of imaging studies. OBJECTIVE: The aim of this study was to describe the characteristics and perioperative outcomes of RCC surgery in very elderly patients (VEP), ≥ 75 years of age. METHODS: This is a retrospective comparative study of 3656 patients who underwent the treatment for RCC from 1990 to 2015 in 28 centers from eight Latin American countries. We compared baseline characteristics as well as clinical and perioperative outcomes according to age groups (less than 75 vs. ≥75 years). Surgical complications were classified with the Clavien-Dindo score. We performed logistic regression analysis to identify factors associated with perioperative complications. RESULTS: There were 410 VEP patients (11.2%). On bivariate analysis, VEP had a lower body mass index (p less than 0.01) and higher ASA score (ASA > 2 in 26.3% vs. 12.4%, p < 0.01). There was no difference in performance status and clinical stage between the study groups. There were no differences in surgical margins, estimated blood loss (EBL), complication, and mortality rates (1.3% vs. 0.4%, p = 0.17). On multivariate regression analysis, age ≥75 years (odds ratio [OR] 2.33, p less than 0.01), EBL ≥ 500 cc (OR 3.34, p less than 0.01), and > pT2 stage (OR 1.63, p = 0.04) were independently associated with perioperative complications. CONCLUSIONS: Surgical resection of RCC was safe and successful in VEP. Age ≥75 years was independently associated with 30-day perioperative complications. However, the vast majority were low-grade complications. Age alone should not guide decision-making in these patients, and treatment must be tailored according to performance status and severity of comorbidities.

Characteristics and Surgical Outcomes in Very Elderly Patients (≥75 years) with Renal Cell Carcinoma: Data from the Latin American Renal Cancer Group

Background: The incidence of renal cell carcinoma (RCC) is increasing globally due to an aging population and widespread use of imaging studies. Objective: The aim of this study was to describe the characteristics and perioperative outcomes of RCC surgery in very elderly patients (VEP), ≥75 years of age. Methods: This is a retrospective comparative study of 3656 patients who underwent the treatment for RCC from 1990 to 2015 in 28 centers from eight Latin American countries. We compared baseline characteristics as well as clinical and perioperative outcomes according to age groups (<75 vs.≥ 75 years). Surgical complications were classified with the Clavien-Dindo score. We performed logistic regression analysis to identify factors associated with perioperative complications. Results: There were 410 VEP patients (11.2%). On bivariate analysis, VEP had a lower body mass index (p < 0.01) and higher ASA score (ASA >2 in 26.3% vs. 12.4%, p < 0.01). There was no difference in performance status and clinical stage between the study groups. There were no differences in surgical margins, estimated blood loss (EBL), complication, and mortality rates (1.3% vs. 0.4%, p = 0.17). On multivariate regression analysis, age ≥75 years (odds ratio [OR] 2.33, p < 0.01), EBL ≥ 500 cc (OR 3.34, p < 0.01), and > pT2 stage (OR 1.63, p = 0.04) were independently associated with perioperative complications. Conclusions: Surgical resection of RCC was safe and successful in VEP. Age ≥75 years was independently associated with 30-day perioperative complications. However, the vast majority were low-grade complications. Age alone should not guide decision-making in these patients, and treatment must be tailored according to performance status and severity of comorbidities. (REV INVEST CLIN. 2020;72(5):308-15)