Angiogenesis in Renal Cell Carcinoma: Molecular Biology, Clinical Manifestations, and Case-Based Insights | Chapter 7 | Newer Frontiers in Urology, Volume II

 

Angiogenesis is the defining biological feature of clear-cell renal cell carcinoma (ccRCC). Loss of Von Hippel–Lindau (VHL) function stabilises hypoxia-inducible factors (HIFs), upregulating vascular endothelial growth factor (VEGF) and allied mediators that produce a hypervascular, leaky, and fragile tumour vasculature. This chapter offers a concise, clinically oriented review of renal cell carcinoma (RCC) angiogenesis centred on an exceptional case: a right-sided ccRCC with intratumoral arteriovenous (AV) shunting and venous collaterals that communicated with the second part of the duodenum, presenting as severe upper gastrointestinal (GI) bleeding. We translate the mechanism into management, emphasising rapid stabilisation, diagnostic angiography, endovascular embolisation, and definitive surgery; then situate contemporary systemic therapy [VEGF/VEGF receptor (VEGFR) tyrosine kinase inhibitors (TKIs), immuno-oncology–TKI (IO–TKI) combinations, and HIF-2α inhibition] within decision frameworks that clinicians can apply. An expanded discussion links vessel biology to imaging signatures, resistance, perioperative strategies, and follow-up care. This case serves as a central framework for demonstrating how timely, multidisciplinary coordination can prevent catastrophic haemorrhage and ensure durable oncological control.

 

 

Author(s) Details

Rajan Ravichandran
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Roshan Reddy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Vivek Meyyappan
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-68-8/CH7

Mediastinal Metastasis 10 Years after Primary Renal Cell Carcinoma: A Case Study and Critical Review | Chapter 3 | Advancement and New Understanding in Medical Science Vol. 7

Late recurrence of renal cell carcinoma (RCC), arbitrarily defined as >10 years post-nephrectomy, is rare. The incidence of late recurrence of metastatic RCC is 11% in patients surviving for 10 years after the initial diagnosis. Here, we reviewed 43 reports comprising 467 cases. Metastasis occurs between a few months and 45 years. We report a new case with a 10-year interval to metastasis. The patient is a seventy-four-year-old female from Iraq. She had a cholecystectomy and then a right radical nephrectomy for renal cell carcinoma in 2006. RCC is the most common renal malignancy (approximately 90% of cases) with high metastatic potential. We offered adjuvant treatment because of the patient’s poor general condition and treatment was well tolerated. Moreover, RCC patients require long-term follow-up, to assist in early detection of metastasis and early treatment.

Author(s) Details:

Mustafa Rifat,
James Cook University Hospital, Middlesbrough, UK.

Usama Nihad Rifat,
Israa Hospital, Amman, Jordan.

Khalid Al-Safi,
Jordan Hospital, Amman, Jordan.

Hassan Z. Annab,
Jordan Hospital, Amman, Jordan.

Please see the link here: https://stm.bookpi.org/ANUMS-V7/article/view/13419

Study on Laparoscopic Partial Nephrectomy: An Approach Towards Surgical Technique, Postoperative Survival, and Tumor Characterization According to VEGF Immunostaining | Chapter 8 | Highlights on Medicine and Medical Science Vol. 7

 In two papers published in 1993, laparoscopic partial nephrectomy (LPN) was first documented. Despite the fact that the surgical procedure was novel in terms of approach, it attempted to replicate open surgery's oncological and reconstructive concepts. In this series, we provide oncological findings and establish 5-year postoperative survival. Due to the crucial role of angiogenesis in the aetiology of renal carcinomas, we also measure the presence of the "Vascular Endothelial Growth Factor" (VEGF). We conducted 67 LPN for localised kidney malignancies at the Decentralized General Acute Zonal Hospital "Evita Pueblo" in Berazategui between 2005 and 2013. Transperitoneal laparoscopic partial nephrectomy was performed as the surgical procedure. The patients were put on a follow-up regimen after surgery. Our surgical procedure allowed us to achieve an average duration of 107 minutes and an ischemia time of 19 minutes, according to the results. Hemorrhage was the most common complication, occurring in 7.6% of patients. Although haemorrhage and bile duct injury necessitated conversion to open surgery in two patients, conversion to radical surgery was not required in any of the cases. Overall survival in clinical stages T1a / T1b was 96.7 percent after 5 years. We may conclude that our LPN technique provides oncological results that are comparable to those of other open or robotic surgical techniques, while also offering the benefits of minimally invasive surgery at a reasonable cost. Postoperative survival is connected to the degree of cell differentiation, which was demonstrated in the current study by immunostaining with VEGF, where we found that tumours with higher marking intensity are directly correlated with worse postoperative survival (p 0.002).

Author (S) Details

Santinelli Flavio
Hospital Zonal General de Agudos Descentralizado 'Evita Pueblo', Berazategui, Buenos Aires, Argentina.

Baldarena Claudio
Hospital Zonal General de Agudos Descentralizado 'Evita Pueblo', Berazategui, Buenos Aires, Argentina.

Mias Fernando
Hospital Zonal General de Agudos Descentralizado 'Evita Pueblo', Berazategui, Buenos Aires, Argentina.

López Gustavo
Hospital Zonal General de Agudos Descentralizado 'Evita Pueblo', Berazategui, Buenos Aires, Argentina.

Inda Ana
Faculty of Medical Sciences, Chair of Cytology, Histology and Embryology 'A', National University of La Plata, Buenos Aires, Argentina.

García Marcela
Faculty of Medical Sciences, Chair of Cytology, Histology and Embryology 'A', National University of La Plata, Buenos Aires, Argentina.

Colaci Pablo
Hospital Zonal General de Agudos Descentralizado 'Evita Pueblo', Berazategui, Buenos Aires, Argentina and Faculty of Medical Sciences, Chair of Cytology, Histology and Embryology 'A', National University of La Plata, Buenos Aires, Argentina.

View Book :- https://stm.bookpi.org/HMMS-V7/article/view/2036

Research on the Prognostic Role of Vascular Endothelial Growth Factor in Renal Cell Carcinoma | Chapter 8 | Highlights on Medicine and Medical Research Vol. 7

 Renal cell carcinoma is the most deadly type of urological cancer. 60% to 70% of RCCs are localised instances for which nephrectomy is the gold standard treatment. At the time of diagnosis, 20% of cases are progressed. Due to their chemo- and radio-resistance, the treatment plan for such individuals remains inadequate. In renal malignancies, Vascular Endothelial Growth Factor is a significant modulator of angiogenesis. Hypoxia Inducible Factor-1 is produced when the von Hippel-Lindau gene is inactivated. Following this, VEGF-A levels in the cancer tissue skyrocket. This promotes distant metastasis, uncontrolled development, and apoptosis resistance, resulting in tumour creation. As a result, targeting VEGF may be useful in the therapy of RCC.

Methods and Materials: A total of 150 tissue blocks from histopathologically confirmed RCC patients were used in this study. The ethical clearance was provided by the Sri Ramachandra Institute of Higher Education & Research (Deemed University) Ethics Committee. The Biotin Streptavidin Immunoperoxidase technique was used to examine VEGF. The scoring for Q has been completed.

Statistical Analysis: The Chi square test and Fischer Exact test were used to evaluate the relationship between VEGF expression in tumour cells and histology, grade, and stage. The statistical package SPSS (version 20.0) was used. P values of less than 0.05 were considered significant.

The goal of this study was to look at the expression of Vascular Endothelial Growth Factor in Renal Cell Carcinoma cases and see if it might be used as a biomarker. Results: In the tumour location, 96.6 percent of RCC cases were VEGF positive, although cells in the nearby normal tissue area showed poor staining. In RCC, tumour angiogenesis has been found to be a major predictor of prognosis.

Conclusion: VEGF inhibition can normalise permeability, increase host immunity, and increase access to therapies like chemotherapy.

Author(s) Details

Deepika Chandrasekaran
Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

R. Padmavathi
Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

Sandhya Sundaram
Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

N. Kathiresan
Department of Surgical Oncology, Apollo Speciality Hospital, Chennai, India.

View Book :- https://stm.bookpi.org/HMMR-V7/article/view/1063

Research on Carbonic Anhydrase IX- an Immunohisto Chemical Marker in Renal Cell Carcinoma | Chapter 1 | Current Topics in Medicine and Medical Research Vol. 9

 Renal cell carcinoma (RCC) has been one of the lethal tumours of increasing concern among the Indian population over the past two decades. In order to help tumour progression by controlling cell proliferation and tumour invasiveness, carbonic anhydrase IX (CA IX) modifies intracellular pH. It is an over-expressed hypoxia-inducible metalloenzyme in cancer cells. Improving host immunity by targeting the CAIX is necessary, thus destroying the progression of the tumour and improving the survival rate. Using 150 tissue blocks of histopathologically proven RCC patients, this research was performed. The ethical clearance was given by the Ethics Committee, Sri Ramachandra Institute of Higher Education & Research (Deemed University). The Biotin Streptavidin Immunoperoxidase approach was used to analyse CAIX. Scoring Q has been completed. To determine the comparison between the CAIX expression in tumour cells and their characteristic features such as histology, grade, and level, the Chi square test was performed. They used SPSS (version 20.0). The P value <0.05 was considered to be important. The objective was to evaluate the expression of Carbonic Anhydrase IX and its function as a possible biomarker in cases of Renal Cell Carcinoma. 74 percent of RCC cases were CA IX positive, while negative staining was seen in the adjacent normal tissue region. In this study, heavy and diffuse staining was demonstrated by most CcRCC patients (91.7 percent). The staining severity was inversely proportional to the grading of the WHO-ISUP. There is a good association in early cases of clear cell RCC with CA-IX expression. As a possible diagnostic marker, it may also prove useful in determining the prognosis and planning therapy for these tumours. Not only do tumour markers provide prognostic information to help classify patients at risk of recurrence or metastasis, but they may also promote the fair use of targeted therapeutic procedures.

Author(s) Details

Deepika Chandrasekaran

Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

R. Padmavathi

Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

Sandhya Sundaram

Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

View Book :- https://bp.bookpi.org/index.php/bpi/catalog/book/322