Displaying publications 61 - 80 of 93 in total

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  1. Clinical prognostic factors and survival outcome in renal cell carcinoma patients--a malaysian single centre perspective
    Yap NY, Ng KL, Ong TA, Pailoor J, Gobe GC, Ooi CC, et al.
    Asian Pac J Cancer Prev, 2013;14(12):7497-500.
    PMID: 24460324
    BACKGROUND: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms.

    MATERIALS AND METHODS: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis.

    RESULTS: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, 9.5±4.3cm, was larger than non palpable masses, 5.3±2.7cm (p<0.001).

    CONCLUSIONS: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

    Matched MeSH terms: Kidney Neoplasms/complications; Kidney Neoplasms/mortality*; Kidney Neoplasms/pathology; Kidney Neoplasms/therapy
  2. Multiphase renal CT in the evaluation of renal masses: is the nephrographic phase necessary?
    Songib NA, Nazri M, Yaakup NA, Nor HM, Sun Z
    Clin Imaging, 2013 Nov-Dec;37(6):1037-42.
    PMID: 24035803 DOI: 10.1016/j.clinimag.2013.08.005
    The aim of this study is to investigate the feasibility of eliminating the nephrographic phase from the four-phase renal computed tomography (CT) imaging to a three-phase protocol without affecting its diagnostic value. Thirty patients undergoing four-phase renal CT scans for assessment of renal lesions (>10 mm) were included in the study. A three-phase renal CT, without nephrographic phase, had similar diagnostic ability to a four-phase renal CT in the detection and characterization of renal lesions. A three-phase CT (plain, corticomedullary, and excretory phase) is therefore adequate in the clinical diagnosis of renal lesions.
    Matched MeSH terms: Kidney Neoplasms/pathology; Kidney Neoplasms/radiography*
  3. Resistance against tumour necrosis factor α apoptosis by the cellular prion protein is cell-specific for oral, colon and kidney cancer cell lines
    Yap YH, Say YH
    Cell Biol Int, 2012 Mar 1;36(3):273-7.
    PMID: 21980981 DOI: 10.1042/CBI20110088
    Since the discovery of PrPC (cellular prion protein), most studies have focused on its role in neurodegenerative diseases, whereas its function outside the nervous system remains obscure. We investigated the ability of PrPC in resisting TNFα (tumour necrosis factor α) apoptosis in three PrPC-transiently transfected cancer cell lines, renal adenocarcinoma ACHN, oral squamous cell carcinoma HSC-2 and colon adenocarcinoma LS174T. PrPC-expressing ACHN and LS174T cells had higher viabilities compared with the mock-transfected cells, while the transient overexpression of PrPC had minimal overall effect on HSC-2 cells due to its high endogenous PrPC expression. Cell cycles were also analysed, with both PrPC expressing ACHN and LS174T cells having a significantly higher proliferative index than mock-transfected cells. Flow cytometry analysis indicated a G1/S-phase cell cycle transition in both PrPC-expressing ACHN and LS174T cells. PrPC resists TNFα apoptosis due to a modest, but statistically significant, cell-specific cytoprotection compared with mock-transfected cells.
    Matched MeSH terms: Kidney Neoplasms/metabolism*
  4. Fulltext Nephrectomy for a case of intrarenal dermoid cyst: was it an appropriate decision?
    Christopher, C.K.H., Praveen, S., Goh, E.H., Tan, G.H., Rozman, Z., Zulkifli, M.Z., et al.
    Journal of Surgical Academia, 2011;1(1):25-27.
    MyJurnal
    Dermoid cyst in a kidney is rarely seen. We report a case of intrarenal dermoid cyst which mimics malignant renal tumour and discuss the dilemma in managing this disease.
    Matched MeSH terms: Kidney Neoplasms
  5. Fulltext Multiple metastatic deposits in the head and neck region from a renal cell carcinoma
    Ishak AI, Md Pauzi SH, Masir N, Goh BS
    Malays J Med Sci, 2010 Oct;17(4):71-4.
    PMID: 22135565 MyJurnal
    Metastatic renal cell carcinoma (RCC) presenting with multiple deposits in the head and neck region is unusual. It is not uncommon for a RCC to metastasise to a distant site after years of a tumour-free period, but most of it would be expected to have a single site of deposit. We report a rare case of a patient who had a nephrectomy 10 years earlier for RCC and presented with tumours in the frontal sinus and posterior pharyngeal wall. Radiological imaging and histology confirmed metastatic RCC at both sites.
    Matched MeSH terms: Kidney Neoplasms
  6. Fulltext Proptosis: a rare presentation of metastatic renal cell carcinoma
    Ho CC, Krishna KK, Praveen S, Goh EH, Lee BC, Zulkifli MZ
    Med J Malaysia, 2010 Sep;65(3):229-30.
    PMID: 21939176
    We present a case of a middle-aged man who was incidentally found to have right renal solid mass while investigating for his left eye proptosis. Computerised tomography (CT) scan confirmed the diagnosis of renal cell carcinoma and the tumour was successfully excised via open surgery. The histopathology examination revealed the 10x7x8 cm mass to be a clear cell type renal cell carcinoma. The rare presentation of this metastatic renal cell carcinoma, its diagnosis and management will be discussed.
    Matched MeSH terms: Kidney Neoplasms/diagnosis*; Kidney Neoplasms/surgery
  7. Fulltext Clinical characteristics of renal cancer in Malaysia : a ten year review
    Singam P, Ho C, Hong GE, Mohd A, Tamil AM, Cheok LB, et al.
    Asian Pac J Cancer Prev, 2010;11(2):503-6.
    PMID: 20843141
    Renal cancer is rare and its incidence is 1.9 per 100,000 in the Malaysian population, which consists of three major ethnic groups (Malay, Chinese and Indians). A retrospective study was her conducted to identify clinical characteristics and ethnic background influences on presentation. The study included all renal cancer patients from a single medical institution over ten years, with a total of 75 cases. Seventy-three patients underwent surgery while 2 received only radiotherapy or chemotherapy. The male to female ratio was 2.75:1. Incidence was equal among the Malay (49.3%) and Chinese ethnic groups (45.3%). Mean age of patients were 57.1 (18-93) years old. There were 26 (37.4%) patients with Stage I disease, 14 (18.7%) at Stage II, 23 (30.7%) at Stage III and 12 (16%) at Stage IV. The Chinese race presented at mean older age (p= 0.02) and later stage of disease (p= 0.046). Patients above 40 years old had more advanced stage disease (p= 0.023). Tumour histology were clear cell (72%), urothelial cell (13.3%), sarcomatoid cell and nephroblastoma each contributed 2.7%. The mean tumour size was 8.1 (2-20) cm. There was substantial agreement between the pre and post operative staging (kappa 0.691). In conclusion we observed significant influences of age and race in the clinical presentation of renal cancer in our institution based population. There was larger male to female ratio and mean tumour size as compared to previous epidemiology studies.
    Matched MeSH terms: Kidney Neoplasms/pathology; Kidney Neoplasms/therapy*
  8. Laparoscopic approach to small renal mass
    Teh GC
    Urol Oncol, 2010 Nov-Dec;28(6):682-5.
    PMID: 21062652 DOI: 10.1016/j.urolonc.2010.03.017
    With maturing functional and oncologic outcomes data, open partial nephrectomy (OPN) has become the standard of care for T1a renal tumor. Laparoscopic approach can provide a speedier recovery with less blood loss and postoperative pain. Presuming adequate laparoscopic expertise, laparoscopic partial nephrectomy can provide equivalent oncologic outcome as for OPN albeit with higher urologic complications rate and longer warm ischemia time. With refinement of technique and use of robotic assistant, the shortcomings of laparoscopic approach can be further reduced. This article is a mini-review on the current status of laparoscopic approach to partial nephrectomy in the management of small renal mass.
    Matched MeSH terms: Kidney Neoplasms/surgery*
  9. Fulltext A retrospective analysis of patients with advanced renal cell carcinoma treated with temsirolimus
    Ng, Christina
    JUMMEC, 2010;13(1):19-23.
    MyJurnal
    The clinical experience of the novel drug temsirolimus on eight patients with metastatic renal cell carcinoma and who were refractory to other forms of treatment is reported. Although none of the patients showed complete or partial response, three patients had stable disease. One patient was prematurely withdrawn due to pneumonitis. Five patients died during the period of observation of twenty months and the median survival time from start of treatment was ten months. Three patients showed no evidence of adverse events (AE). Five patients showed dyslipidemia and two had pneumonitis for which, the drug had to be withdrawn in one of them. None had significant leucopenia. We conclude that temsirolimus has activity even in heavily pretreated patients in advanced renal cell carcinoma and in addition, has the benefits of ease of administration and good tolerability.
    Matched MeSH terms: Kidney Neoplasms
  10. Fulltext Renal angiomyolipomas in the University of Malaya Medical Centre: its spectrum of presentation and management
    Koh, P.S., Muhilan, P., Dublin, N., Razack, A.H.
    JUMMEC, 2009;12(1):39-43.
    MyJurnal
    Renal angiomyolipoma, once considered a rare benign renal tumour, is relatively common these days. They account for 0.3-3.0% of all renal masses. Histologically, it is composed of adipose tissue, smooth muscles and blood vessels. Here, we wish to highlight five cases of renal angiomyolipomas which were presented to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, over a two-year period between June 2005 and June 2007. This study wish to illustrate its varied clinical presentation and the management undertaken for each underlying condition. These cases were presented in the form of spontaneous perirenal haemorrhage, a large asymptomatic renal mass, a small asymptomatic renal mass, a symptomatic renal angiomyolipoma and a case of renal angiomyolipoma mimicking a renal tumour. Each of these cases varied in its clinical presentation; thus, management has become very challenging to clinicians ranging from conservative management to active intervention, be it operatively or non-operatively.
    Matched MeSH terms: Kidney Neoplasms
  11. Probucol modulates iron nitrilotriacetate (Fe-NTA)-dependent renal carcinogenesis and hyperproliferative response: diminution of oxidative stress
    Iqbal M, Okazaki Y, Okada S
    Mol Cell Biochem, 2007 Oct;304(1-2):61-9.
    PMID: 17487455
    Probucol is a clinically used cholesterol-lowering drug, with pronounced antioxidant properties. We have reported previously, that dietary supplementation of probucol enhances NAD(P)H:quinone reductase (Iqbal M, Okada S (2003) Pharmacol Toxicol 93:259-263) and inhibits Fe-NTA induced lipid peroxidation and DNA damage in vitro (Iqbal M, Sharma SD, Oakada (2004) Redox Rep 9:167-172). Further to this, in the present study, we evaluated the modulatory effect of probucol on iron nitrilotriacetae (Fe-NTA) dependent renal carcinogenesis, hyperproliferative response and oxidative stress. In Fe-NTA alone treated group, a 20% renal cell tumor incidence was recorded whereas, in N-diethylnitrosamine (DEN)-initiated and Fe-NTA promoted animals, the percentage tumor incidence was increased to 70% as compared with untreated controls. No tumor incidence was recorded in DEN-initiated, nonpromoted group. Diet supplemented with 1.0% probucol fed prior to, during and after Fe-NTA treatment in DEN-initiated animals afforded >65% protection in renal cell tumor incidence. Probucol fed diet pretreatment also resulted a significant and dose dependent inhibition of Fe-NTA induced renal ornithine decarboxylase (ODC) activity. In oxidative stress studies, Fe-NTA alone treatment enhanced lipid peroxidation, accompanied by a decrease in the level of GSH, activities of antioxidants and phase II metabolizing enzymes in kidney concomitant with histolopathological changes. These changes were significantly and dose-dependently alleviated by probucol fed diet. From this data, it can be concluded that probucol can modulates toxic and tumor promoting effects of Fe-NTA and can serve as a potent chemopreventive agent to suppress oxidant induced tissue injury and carcinogenesis, in addition to being a cholesterol lowering and anti-atherogenic drug.
    Matched MeSH terms: Kidney Neoplasms/chemically induced*; Kidney Neoplasms/pathology; Kidney Neoplasms/prevention & control
  12. Fulltext Renal cell carcinoma in a von Hippel-Lindau syndrome: when should phaeochromocytoma be anticipated?
    Azarisman SM, Nor Azmi K
    Singapore Med J, 2007 Aug;48(8):779-82.
    PMID: 17657389
    A 39-year-old man was diagnosed with von Hippel-Lindau syndrome, which was associated with retinal haemangioblastoma, cervical cord haemangioblastoma and bilateral renal cell carcinoma. He subsequently underwent an arterial embolisation and cervical laminectomy, following a spinal angiogram of the cervical lesion. He also had a right radical nephrectomy, with no perioperative complications. However, on admission for the left radical nephrectomy, he was noted to have preoperative hypertension. Further investigation revealed an enlarged left adrenal gland on abdominal computed tomography scan and raised urinary catecholamines. We discuss the risk of renal cell carcinoma and phaeochromocytoma arising concomitantly in von Hippel-Lindau syndrome, and how best to investigate and manage them.
    Matched MeSH terms: Kidney Neoplasms/complications*; Kidney Neoplasms/surgery
  13. Fulltext Renal angiomyolipoma with inferior vena caval involvement
    Haritharan T, Sritharan S, Bhimji S
    Med J Malaysia, 2006 Oct;61(4):493-5.
    PMID: 17243531 MyJurnal
    Renal angiomyolipomas are innocuous benign tumours which rarely behave aggressively. This is a case of a 48 year old Malay lady presenting with right sided abdominal pain associated with a large right sided abdominal mass. She was diagnosed with renal angiomyolipoma of the right kidney complicated by inferior vena caval tumour thrombosis. She successfully underwent a radical nephrectomy and inferior vena caval thrombectomy using cardiopulmonary bypass and deep hypothermic circulatory arrest.
    Matched MeSH terms: Kidney Neoplasms/pathology*; Kidney Neoplasms/surgery
  14. Secondary B-cell acute lymphoblastic leukemia following Wilms' tumor: clinical and in vitro chemosensitivity studies
    Ariffin H, Muthukkumaran T, Stanslas J, Sabariah AR, Veerasekaran N, Lin HP
    Leuk Lymphoma, 2005 Aug;46(8):1233-7.
    PMID: 16085568
    We report the clinical features and in vitro chemosensitivity assay findings of a 13-year-old girl who developed secondary B-cell acute lymphoblastic leukemia (ALL) 7 years after a diagnosis of Wilms' tumor. The patient was treated using the Berlin - Frankfurt - Muenster (BFM) ALL chemotherapy protocol with poor response to initial therapy before succumbing to sepsis. An in vitro chemosensitivity assay on her peripheral blood lymphoblasts was performed while she was undergoing induction therapy and showed a high level of resistance to drugs commonly used for ALL therapy, e.g. steroids, anthracyclines, vincristine and L-asparaginase. The mechanism of chemoresistance was not elicited, but was probably not related to P-glycoprotein (P-gp) over-expression. We believe that the in vitro chemosensitivity assay is a good indicator of cellular response to chemotherapy and may provide reliable information for the basis of the selection of drugs to be used for the treatment of similarly rare patients rather than relying on "standard" protocols.
    Matched MeSH terms: Kidney Neoplasms/complications*; Kidney Neoplasms/diagnosis; Kidney Neoplasms/drug therapy
  15. Fulltext Mucinous adenocarcinoma of the renal pelvis associated with lithiasis and chronic gout
    Kaur G, Naik VR, Rahman MNG
    Singapore Med J, 2004 Mar;45(3):125-6.
    PMID: 15029415
    Diffusely-infiltrating mucinous adenocarcinoma of the renal pelvis associated with lithiasis and chronic gout is reported in a 61-year-old Malay man. The patient underwent left nephrectomy and vesiculo-lithotomy. This tumour is postulated to arise in response to chronic irritation of the urothelium.
    Matched MeSH terms: Kidney Neoplasms/etiology*; Kidney Neoplasms/pathology*; Kidney Neoplasms/surgery
  16. Fulltext Diffuse neonatal haemangiomatosis: a rare cause of haemorrhagic shock and refractory coagulopathy in the newborn
    Rohana J, Boo NY, Hayati AR, Baizura J
    Med J Malaysia, 2002 Sep;57(3):364-7.
    PMID: 12440278
    A term newborn infant developed hypovolaemic shock shortly after birth. She was pale with gross hepatomegaly. She required multiple boluses of intravenous fluids, blood products as well as inotropic support. Blood investigations showed persistent thrombocytopenia, anaemia and disseminated intravascular coagulopathy (DIC). She also developed heart failure. She finally succumbed on the eleventh day of life. Autopsy revealed haemangiomatosis involving the liver, lungs, gastrointestinal tract, kidneys and adrenals.
    Matched MeSH terms: Kidney Neoplasms/complications*; Kidney Neoplasms/congenital*
  17. Radiological parameters of bleeding renal angiomyolipoma
    Koh KB, George J
    Scand. J. Urol. Nephrol., 1996 Aug;30(4):265-8.
    PMID: 8908645
    Angiomyolipomas are rare tumours of the kidney which have a tendency to bleed. We studied the clinical and radiological features of 11 patients from our institution to identify features which may be predictive of a massive haemorrhage. Tumours more than 6 cm in diameter were found to bleed and the demonstration of pseudoaneurysms on contrast CT scanning was associated with massive haemorrhage. We conclude that large angiomyolipomas should be treated to avoid haemorrhage and the detection of pseudoaneurysms should prompt urgent treatment.
    Matched MeSH terms: Kidney Neoplasms/complications
  18. Implications of p53 protein expression in clear cell sarcoma of the kidney
    Cheah PL, Looi LM
    Pathology, 1996 Aug;28(3):229-31.
    PMID: 8912350
    Eight histologically-confirmed cases of clear cell sarcoma of the kidney (CCSK) were studied for possible mutations in the p53 tumor suppressor gene by the immunohistochemical demonstration of mutant p53 proteins using a monoclonal (DO7: Dako) and a polyclonal (AB565: Chemicon) antibody to p53 protein. All cases exhibited p53 protein nuclear immunopositivity, although in varying numbers of tumor cells and with different staining intensities. p53 protein (DO7 or AB565) was expressed in < 25% of the tumor cells in four (50%) of the cases, including the one case with a known long term survival of 13 years from the time of diagnosis. The other tumors showed p53 protein immunopositivity in > 25% of the tumor cells when stained with either DO7 or AB565 or both. The intensity of staining, graded on visual impression into weak, moderate or strong, did not correlate well with the ratio of positive staining tumor cells. While this study is unable to clarify the relative prevalence and importance of p53 mutational events in the pathogenesis of this aggressive renal tumor of childhood, it is reasonably suggestive that alterations in the p53 tumor suppressor gene do occur in CCSK.
    Matched MeSH terms: Kidney Neoplasms/genetics; Kidney Neoplasms/metabolism*; Kidney Neoplasms/pathology
  19. Fulltext Spontaneous rupture of renal angiomyolipoma presenting as acute abdomen
    Koh KB, Wightman JA, George J
    Med J Malaysia, 1996 Mar;51(1):148-50.
    PMID: 10967998
    Five cases of renal angiomyolipoma which underwent spontaneous rupture are described. These patients presented as an "acute abdomen" for which the diagnosis was not initially apparent. A high index of suspicion is required to make the diagnosis even with modern imaging techniques. The treatment of these tumours is discussed.
    Matched MeSH terms: Kidney Neoplasms/diagnosis*
  20. Immunohistochemical expression of p53 proteins in Wilms' tumour: a possible association with the histological prognostic parameter of anaplasia
    Cheah PL, Looi LM, Chan LL
    Histopathology, 1996 Jan;28(1):49-54.
    PMID: 8838120
    Wilms' tumour (nephroblastoma) has been associated with chromosomal abnormalities at the 11p13, 11p15 and 16q regions. A study into the possibility of mutations occurring within p53, the ubiquitous adult tumour suppressor gene, in Wilms' tumour was carried out. Thirty-eight cases were studied. Of these 36 were categorised into the favourable histology group and two into the unfavourable histology group based on the National Wilms' Tumour Study criteria. Archival formalin-fixed, paraffin-embedded tissue sections from each case were stained with a polyclonal (AB565:Chemicon) and a monoclonal (DO7:Dako) antibody raised against p53 protein using a peroxidase-labelled streptavidin biotin kit (Dako). 'Cure' (disease-free survival of 60 months or longer) was documented in 39% of cases with favourable histology tumours. Eleven percent in this group succumbed to the disease. Both cases with unfavourable histology died. Four out of 36 (11%) tumours with favourable histology demonstrated weak to moderate staining with both AB565 and DO7 in more than 75% of tumour cells. In contrast, p53 protein expression in unfavourable histology tumours was significantly increased compared with the favourable histology group (P = 0.021) with both cases demonstrating immunopositivity in > 75% of tumour cells when stained with AB565 and DO7. The intensity of staining ranged from moderate to strong in both cases. It appears from this preliminary study that the immunohistochemical expression of p53 protein in Wilms' tumour, presumably a result of mutation in the p53 tumour suppressor gene, correlates with histological classification, histological categorisation being one of the useful features in the prognostic assessment of Wilms' tumours.
    Matched MeSH terms: Kidney Neoplasms/genetics; Kidney Neoplasms/metabolism; Kidney Neoplasms/pathology*
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