Tetsuro Onishi

Prognostic evaluation of transcatheter arterial embolization for unresectable renal cell carcinoma with distant metastasis.

Objective To evaluate the efficacy of transcatheter arterial embolization (TAE) in patients with unresectable renal cell carcinoma (RCC) and distant metastasis at the time of diagnosis.

Gender as a prognostic factor in patients with renal cell carcinoma

Objective  To evaluate gender as a prognostic factor in patients with renal cell carcinoma (RCC), using a retrospective review of patients with RCC stratified according to gender and analysing factors affecting prognosis.

Prognostic implications of histological features in patients with chromophobe cell renal carcinoma

Objective  To assess the relationship between the histological features of renal chromophobe cell carcinoma (CCC) and clinical outcome in patients with renal cell carcinoma.

Cyst‐associated renal cell carcinoma: Clinicopathologic characteristics and evaluation of prognosis in 27 cases

No consistent clinicopathologic characteristics of cyst‐associated renal cell carcinoma (CRCC) have previously been determined.

The prevalence of renal cell carcinoma: A nation‐wide survey in Japan in 1997

Abstract Background: The present study was conducted to investigate the incidence of renal cell carcinoma by sex, age group and different regions in Japan.

Histological features of hypovascular or avascular renal cell carcinoma: the experience at four university hospitals.

AbstractBackground. We aimed to evaluate the pathological features of hypovascular or avascular renal cell carcinoma (RCC), by the retrospective review of the histological features that coincide with hypovascular or avascular RCC. Methods. Seven hundred and ninety-one patients who underwent both preoperative angiography and nephrectomy were examined. Of these patients, the 126 patients (15.9%) who showed hypovascular or avascular angiographic features were selected. Patients with hemorrhage or cyst(s), or with at least 50% necrosis or more in the tumor, and those with renal tumor metastatic to the kidney were excluded. The criteria proposed by the World Health Organization (1998) were adopted for the histological classification. Results. Papillary RCC was the most frequently observed hypovascular or avascular renal tumor (44 cases; 34.9%). The vascularity differed among the variants, i.e., some cases had a basophilic and solid variant with avascular features, while the remaining cases had wide stromal organization showing hypovascular features. The second most frequently observed hyporascular or avascular RCC was chromophobe cell carcinoma (35 cases; 27.8%). No difference in vascularity was detected between variants, except for 2 cases with sarcomatoid changes (avascular features). The third most frequently observed hypovascular or avascular RCC was cyst-associated RCC (29 cases; 23%). All of the 7 RCCs originating in a cyst showed avascular features, and the remaining 22 cystic RCCs showed hypovascular features. The remaining hypovascular or avascular RCCs were cases of clear cell carcinoma accompanied by sarcomatoid changes (8 cases; 6.3%), spindle cell carcinoma (5 cases; 4.0%), and collecting-duct carcinoma (5 cases; 4.0%). Conclusion. Hypovascular or avascular RCC can be categorized as non-clear cell carcinoma and some clear cell carcinoma accompanied by sarcomatoid changes.

A low-dose combination therapy of interleukin-2 and interferon-α is effective for lung metastasis of renal cell carcinoma: a multicenter open study

BackgroundTo confirm the usefulness of a combination therapy of interleukin-2 (IL-2) and interferon-α (IFN-α) against metastatic renal cell carcinoma, the recommended dose of IFN-α to use in combination with low-dose IL-2 was determined (phase 1). Efficacy and safety at this dose was evaluated (phase 2).MethodsIn phase 1, the dose of IL-2 was fixed at 0.7 × 106 Japan reference unit (JRU)/person for 5 days a week. The dose of IFN-α was increased from 3 × 106 IU for 3 days a week (level I) to 6 × 106 IU for 3 days a week (level II) and to 6 × 106 IU for 5 days a week (level III).ResultsIn phase 1, 10 patients were registered, with 9 (3 at each level) able to be evaluated. Because grade 3 and grade 4 neutropenia were observed at level III in 1 patient each, level II was found to be the recommended regimen. The response rate in phase 1 was 44.4% (4/9). In phase 2, 46 patients were registered, with a response rate in 37 patients, classified as per protocol set (PPS), of 21.6% (8/37). Toxicities observed were primarily flu-like symptoms due to cytokines, and gastrointestinal symptoms. Leukocyte abnormalities were observed, but they were milder and tolerable.ConclusionIn the 46 patients evaluated in phase 1 and phase 2, the response rate was 26.1% (12/46), being highest in 38.7% (12/31) of those who were nephrectomized, and with only lung metastases.

An assessment of the immunological status of patients with renal cell carcinoma based on the relative abundance of T-helper 1- and -2 cytokine-producing CD4+ cells in peripheral blood

Objective To assess the immunological status of patients with renal cell carcinoma (RCC), by analysing the proportion of cluster‐of‐differentiation 4‐positive (CD4+) cells showing intracellular cytokine production, i.e. interferon‐γ derived from T‐helper (Th) 1 and interleukin‐4 derived from Th2 cells, among peripheral blood lymphocytes from these patients

Interferon-alpha and 5-fluorouracil therapy in patients with metastatic renal cell cancer : An open multicenter trial

Abstract Objectives. Recent clinical trials have implied the cytotoxic and antiproliferative effects of combining 5-fluorouracil and interferon-alpha in the treatment of metastatic renal cell cancer. We therefore conducted an open multicenter trial to test the efficacy of such a combination on this cancer. Methods. Human lymphoblastoid interferon (3 MIU per patient) was administered subcutaneously three times weekly for 12 weeks, while 5-fluorouracil was administered (600 mg/m 2 /day) as a continuous infusion for the first 5 days, followed by an intravenous bolus infusion of 600 mg/m 2 once a week from the 3rd week until the 12th week. Results. Of the 63 patients entered into the trial, 55 were eligible and evaluable for systemic toxicities, and 53 were evaluable for their response. All patients had undergone a prior nephrectomy, and their European Cooperative Oncology Group (ECOG) performance status ranged from 0 to 3 (median 0). Three complete and eight partial responses were induced, with an overall response rate of 20.0%. The median time to progression and the median survival time were 11 and 33 months, respectively. World Health Organization grade 3 toxicities were observed in 8 patients; however, no grade 4 toxicities or toxicity-related deaths were noted. Conclusions. Combination therapy of interferon-alpha plus 5-fluorouracil at the above-described dosage and schedule produced no better responses than interferon monotherapies. Prolongation of survival could be attributable to the fair performance status of the patients. This regimen has limited value for the treatment of patients with advanced renal cell cancer.

Staging of Renal Cell Carcinoma by Computed Tomography

To evaluate the efficacy of computed tomography (CT) in the diagnostic workup of renal cell carcinoma, CT findings were correlated with surgical and pathological findings in 40 cases. Fifteen cases without obliteration of perinephric fat or thickening of Gerotas fascia were confined within the renal capsule. Eighteen lesions showing anatomic contact with adjacent organs were either within the renal capsule or Gerotas fascia but never beyond Gerotas fascia. Two cases (Stage II) showed thickening of Gerotas fascia and two cases (Stage IV) showed tumor infiltration into the spleen. Computed tomography was found to be a useful method for the investigation of tumor thrombosis and lymph node metastasis.