ABO(H) antigens and beta-2 microglobulin in transitional cell carcinoma: predictors of response to intravesical bacillus Calmette-Guerin

Article Abstract:

Superficial transitional cell carcinoma, a form of bladder cancer, is one of the very few cancers that is actually treated with bacteria. BCG, which stands for bacillus Calmette-Guerin, is a strain of bacteria that was developed as a vaccine against tuberculosis. However, when injected directly into the cavity of the bladder, these bacteria bring about a remission of bladder cancer in many, but not all, patients. The success of the treatment seems to be related to the development of a successful immune response against the bacteria. A fundamental characteristic of the response to tuberculosis bacteria is the development of granulomas, or clusters of granular white blood cells which attempt to encase the bacteria that they can not successfully destroy. Patients who develop granulomas within their bladders seem to be more likely to survive their cancers than those who do not. Of course, it is very important to learn more about the features that distinguish the patients who respond to therapy from those who do not. For this reason, the expression of specific antigens on the bladder cancer cells was examined in 15 patients. It is already known that tumors which do not express the antigens of the ABO blood group system or another antigen called beta-2 microglobulin are likely to be more aggressive. (The ABO system was discovered as a blood group, but is found in other organs as well.) The data from these 15 patients were analyzed to determine if the presence or absence of these antigens affects the patient's response to BCG. It was found that patients with either antigens of the ABO system or beta-2 microglobulin were likely to respond to treatment with BCG. Furthermore, the patients most likely to respond to BCG treatment were patients whose tumor cells expressed both antigens of the ABO system and beta-2 microglobulin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prognosis, Cell surface antigens, Bladder cancer

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Long-term results of simple and radical nephrectomy for renal cell carcinoma

Article Abstract:

Attempts to treat renal cell carcinoma, a form of kidney cancer, with radiation or chemotherapy have been largely unsuccessful. Only surgery is effective against this form of cancer. However, the surgery can be radical, in which all the accessory tissues are removed with the kidney, or simple, in which only the cancerous kidney is removed. In an attempt to evaluate the relative effectiveness of these two methods, researchers tabulated the cases of 109 patients, 55 who underwent simple nephrectomy (kidney removal) and 54 who underwent radical nephrectomy. The patients were not randomized; the choice of treatment in all cases was up to the individual surgeon involved. Overall, the mortality due to metastatic disease (spreading of the cancer) was higher among the patients who had simple nephrectomy than among those who had radical nephrectomy, namely 53 percent versus 26 percent, respectively. However, the authors also analyzed the patients according to the stage of disease. When Stages I through IV were considered individually, the patients treated with radical nephrectomy survived longer for Stages I through III, but the differences are not statistically significant. The authors suggest that simple nephrectomy is just as effective as radical nephrectomy. Furthermore, they suggest that if simple nephrectomy is just as good as radical, then it might be possible to treat patients with renal cell carcinoma using only a partial nephrectomy, saving the portion of the kidney not immediately involved with the cancerous growth. (Consumer Summary produced by Reliance Medical Information, Inc.)

Carcinoma, Renal cell, Renal cell carcinoma

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Enucleation of tumor versus partial nephrectomy as conservative treatment of renal cell carcinoma

Article Abstract:

Radical nephrectomy, in which a kidney and all adjacent tissues are removed, has been the treatment of choice for kidney cancer since a 1969 report demonstrated its superiority. However, for patients with renal insufficiency, or only one kidney, this operation would mean lifelong dialysis or a kidney transplant. Therefore, for some patients, it might be preferable to attempt to remove either the tumor itself or a larger piece of the kidney containing the tumor. The removal of only the tumor, called enucleation, was compared with partial nephrectomy in a series of 17 patients. The overall five-year survival rate was 58.8 percent. Despite concerns that enucleation runs the risk of failing to remove some tumor, it was found that there were no significant differences between the two procedures in terms of recurrence or survival. Partial nephrectomy is preferred to guarantee wider margins around the tumor, enucleation is a reasonable alternative for some patients. However, radical nephrectomy remains the treatment of choice for patients for whom the procedure is possible. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Nephrectomy

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