Real-life experience of patients with sarcomatoid renal cell carcinoma: a multicenter retrospective study

Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant

Perspective of turkish medicine students on cancer, cancer treatments, palliative care, and oncologists (ares study): A study of the palliative care working committee of the turkish oncology group (TOG)

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913–2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15–iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840–841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words “cancer” and “oncologist” meant for the students. The participant students were analyzed in two study groups; “group 1” (n = 1.255) were phases I and II students that had never attended an oncology lesson, and “group 2” (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of “death” (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students’ understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country. © 2018, American Association for Cancer Education

Nephrotic syndrome preceding multiple myeloma: Case report [Nefrotik sendroma öncelik eden multipl miyeloma]

Membranoproliferative glomerulonephritis (MPGN) is the most common cause of nephrotic syndrome in young adults. This is a unique clinical entity developing secondary to autoimmune disorders or infections, and renal failure may be the presenting feature of the disease. Here we reported a case with nephrotic syndrome (NS) diagnosed 2 years before with multiple myeloma (MM). At the beginning, hypertension, edema, anemia, moderate renal failure, hypoalbuminemia, severe proteinuria and dyslipidemia were found. She was treated with prednisolone plus conservative measures including anti-hypertensives, angiotensin converting enzyme inhibitor (ACEI), dipyridamol and low salt diet. Two years later, MM was detected and treated with anti-neoplastic agents. Remission was achieved both for the MM and for the renal disease. At the end of 4 years after the diagnosis of MM, relapse occurred without renalfailure. It is known that NS accompanies to MM, but NS preceding MM is very rare. For this reason, the possibility of the development of a malignant disease should be considered in cases with idiopathic glomerulonephritis. © 2013 by Türkiye Klinikleri

Glomerular disease in patients with malignant disease: four cases and review of literature.

Renal involvement may occur in cases with malignant disorders. Glomerular injury may be the first sign of these diseases and may predict the overall survival. In some cases., glomerular injury may be associated with tumor antigens, and in some others, viruses cause renal injury together with underlying malignant disease. Here we report four cases with malignant diseases and accompanying glomerular injury and review the literature

Glomerular disease in patients with malignant disease: Four cases and review of literature

PubMedID: 15717627Renal involvement may occur in cases with malignant disorders. Glomerular injury may be the first sign of these diseases and may predict the overall survival. In some cases, glomerular injury may be associated with tumor antigens, and in some others, viruses cause renal injury together with underlying malignant disease. Here we report four cases with malignant diseases and accompanying glomerular injury and review the literature

Spontaneous regression of bilateral surrenal haematoma and subclinical hypoaldosteronism in a patient with renal amyloidosis secondary to Familial Mediterranean Fever

PubMedID: 11229653This report describes a patient with Familial Mediterranean Fever (FMF) associated with renal amyloidosis, bilateral surrenal haematomas and hypoaldosteronism which was clinically asymptomatic. The deposition of AA amyloide was found on the renal and bone marrow biopsies. Bilateral surrenal haematoma regressed after six month from the first events. Colchicine therapy controlled the attacks of the disease

Investigations on yield an quality characteristics of some stawberry cultivars grown under Adana and Pozanti ecological conditions [Bazi çilek çeşitlerinin adana ve pozanti ekolojik koşullarindaki verim ve kalite kriterleri üzerinde araştirmalar]

These investigations were carried out during 1991-92 and 1992-93 seasons in Adana (altitude: 50m) and Pozanti (altitude: 1100m) ecological conditions in order to compare the behaviour of 8 strawberry cvs (Aliso, Tioga, Tufts, Vista, Pocahontas, Cruz, Douglas and Dana) with summer planting system. The plantings were repeated each year in Adana but the plants of the first year were kept in their places and their second crop was obtained in second year. During 1991-92 season the yield per plant in Adana was found much higher than that of the Pozanti. However, since the second crop of Pozanti's plants was quite satisfactory, this type of growing is recommended. In Adana spring rains during the flowering and peak season reduce the yield therefore here protected cultivation is recommended. When the yield/plant, average size of the fruits, TSS were considered, Tufts, Vista and Cruz were found superior than the other cvs tested

Flower bud formation in ottoman (female type) strawberry cultivar

The aim of this work was to investigate flower bud formation in the strawberry cultivar Ottoman which is a local female type, very resistant to chlorosis and very rich in aroma. Plant samples were taken all the year round and examined under a binocular dissecting stereomicroscope for the initiation of flower buds, differentiation and development of floral organs. In order to study the aborted anthers during the stages of floral development, the materials were sectioned using a microtome. The sections were stained with hematoxylin and examined under a light and/or fluorescent microscope. It was found that until Stage V of flower development there was no abnormality in the growth and development of the anthers. But after this stage the growth of the filaments slowed down and the anthers became flattened and dried. There was no sign of pollen formation in them. However, the pistils developed gradually until the balloon stage, and the sepals and petals appeared to be normal

Drug induced pericarditis in a patient with chronic renal failure

PubMedID: 12380914Drug induced pericarditis is reported very rarely. We presented a patient with pericarditis due to antituberculosis therapy induced pericarditis and chronic renal failure. We did not find clinical and serologic findings of pseudo-lupus clinical symptoms and pericarditis regressed in a short time with cessation of antituberculosis drugs and initiated steroid

Effect of different rootstocks on the bud-take, nutrient absorption rate and growth of some apricot cultivars

In this work 5 rootstocks (apricot seedling, Nemaguard, GF-31, Pixy, a plumcot) and 7 cultivars (as dried apricot cvs: Hacihaliloglu, Kabaasi, as table apricot cvs: Karacabey, Aprikoz, Beliana, Rouge du Roussillon, J.Foulon) were used. The rates of bud-takes of all experimental cvs were low on Pixy rootstocks. From the stand point of stem diameters and heights it was found that apricot seedlings and plumcot's rooted cuttings were the strongest, GF-31's rooted cuttings were strong and Nemaguard and Pixy seedlings were weak rootstocks. Among the cvs, Kabaasi seemed to be weaker than the others. Branching of the nursery plants was less on Pixy than the other rootstocks. The uptakes of N, P, Ca and Mg were affected by the rootstocks. In the leaves of the cvs budded on different rootstocks the levels of N and P were found normal but the K levels were generally very high due to the high K contents of the soils. The leaves were found deficient in Ca and Mg because of the antagonistic effect of K, Fe, Mn, Zn and Cu contents of the leaves were found adequate and it seemed that their uptakes with the exception of that of Fe, were not affected by the rootstocks