Immunoperoxidase Staining of Fine-Needle Aspiration Biopsies of Renal Cell Carcinoma Using Tumor-Specific Monoclonal Antibody

In 30 nephrectomy specimens, fine needle aspiration biopsies (FNAB) were performed both in the tumor and in the macroscopically normal part of the kidney: 18 were well differentiated renal cell carcinoma (RCC), 6 were moderately differentiated RCC, 4 were poorly differentiated RCC, and 2 were oncocytomas. FNAB was also performed in a bone metastasis of RCC. FNAB materials were stained using the immunoperoxidase method with RCC-specific monoclonal antibody and were compared with the staining of frozen sections. In all cases where tumor-antigen expression could be demonstrated in the frozen sections, a FNAB had already proven positive. There were only 2 false-negative cases where sufficient c…

Immunotherapy of Metastasizing Renal Cell Carcinoma

119 patients with stage-IV renal cell carcinoma were treated using immunotherapy with autologous tumor vaccine. The immunization was carried out at monthly intervals, the patients were restaged every

Mainz Pouch for Augmentation Bladder Substitution or Continent Urinary Diversion

Extracorporeal Perfusion of the Tumor Bearing Human Kidney Using Tumor-Specific Monoclonal Antibodies: A Therapeutic Model

The use of monoclonal antibodies for tumor specific in vitro diagnosis is well established. With the possibility of producing tumor specific monoclonal antibodies, not only the in vitro application but also the in vivo use for tumor imaging is of great interest (Bander 1984; Mitchell and Oettgen 1982; Moon et al. 1983; Ritz et al. 1981). Methodology for radiolabelling of immunoglobulines is a well established and simple biochemical procedure thus making these antibodies ideal for immuno-szintigraphy (Greenwood et al. 1963; Hunter and Greenwood 1962; Mach et al. 1981; Scheinberg et al. 1982; Solter et al. 1982). Using alpha- or beta-emitting isotopes the therapeutic use of antibodies as tumo…

Postersitzung 6: Extrakorporale Stoßwellenlithotripsie (ESWL) bei komplizierter Urolithiasis

Die Nierensteinbehandlung hat sich mit Einfuhrung von PCNL und ESWL innerhalb weniger Jahre dramatisch gewandelt. Die Kombination von PCNL plus ESWL minimiert die Nachteile beider Techniken, die sie in ihrer alleinigen Anwendung bei der Behandlung von Ausgussteinen aufweisen. Uber unsere ersten Erfahrungen mit diesem Therapiekonzept haben wir bereits berichtet [1]. Bisher ist jedoch noch unklar, welche Spatergebnisse in diesen mit PCNL plus ESWL behandelten Patienten erzielt werden. In dieser Studie haben wir daher Patienten nachuntersucht, die 1984 und 1985 an unserer Klinik wegen Ausgussteinen kombiniert mit PCNL plus ESWL behandelt worden waren.

Slightly radiopaque uric acid calculi: impact upon therapeutic considerations?

Ten patients with slightly radiopaque urinary calculi were treated by percutaneous litholapaxy or even open surgery. The stone analysis revealed uric acid as the main stone composite suggesting that these patients should have been treated by oral litholysis alone alkalinizing the urine and decreasing uric acid levels with allopurinol. CT density measurements proved that concrements with HE less than 600 can be successfully dissolved by oral medication alone. Twenty-four patients were subsequently treated by oral citrate alkalinizing the spontaneous urine to pH 6.8-7.2 dissolving even large staghorns within 6-8 weeks. CT density measurements have become a routine diagnostic procedure when po…

Active immunotherapy of stage IV renal cell cancer using autologous tumor cells

A total of 53 patients with stage IV renal cell carcinoma were treated by vaccination with autologous tumor cells in Candida-antigen after palliative tumor nephrectomy. Follow-up has been up to 9 years. Complete remission within 48 months after nephrectomy was observed in 3 patients, while 6 showed partial remission and 18 are stable with disease. Of 26 patients with rapid progression, 17 died within 1 year after operation. The best response was seen in metastases to the liver and lung. CNS-lesions or bone metastases do not appear to respond to this treatment. We conclude that this mode of therapy is beneficiary to a certain group of patients and should be offered, as no severe side effects…

Conservative surgery of renal cell carcinoma.

Abstract From 1967 to 1985 conservative surgery (enucleation, n = 49; partial resection, n = 7) was performed for renal tumors in 57 patients (age 31-77, mean 54.8 years). Imperative indications for conservative surgery (n = 29) were chronic renal failure, benign pathology of contralateral kidney, functional or anatomical solitary kidney, and bilateral tumors. Elective conservative surgery (n = 28) was done for small, peripherally located lesions, in cases of uncertain malignancy and in one tumor detected by chance during stone surgery. Tumors removed for imperative indications were 2-11 cm (mean 5.8 cm) in size. In the elective group, tumor size ranged from 1 to 7 cm (mean 3.3 cm). Follow-…

Local excision of urothelial cancer of the upper urinary tract.

Abstract In 9 of 93 patients (9.7%) with urothelial cancer of the upper tract (7 renal pelvis tumors, 3 ureteral tumors), conservative surgery was employed using a free peritoneal autotransplant for replacement of the renal pelvis in 5 kidneys. Absolute indications for conservative surgery were solitary kidneys/nonfunctioning contralateral kidneys in 4 patients and bilateral tumors in 1 patient. Local recurrences developed 1-3 years after operation in 4 of 6 kidneys (3 patients), 3 of which had grade-2 and grade-3 primary lesions. All patients were treated successfully by repeated local excision. In the presence of a normal contralateral kidney, local tumor excision was done electively in 4…

Extracorporeal shock wave lithotripsy of urinary calculi: experience in treatment of 3,278 patients using the Siemens Lithostar and Lithostar Plus.

Between March 1986 and June 1989, 3,278 patients with upper urinary tract calculi were treated at our medical center with the Lithostar lithotriptor. The stones were located in the calices in 41.9% of the cases, renal pelvis in 25.7% and ureter in 32.4%. Perirenal hematoma was noted in 0.5% of the patients but this resolved spontaneously within a few days. Auxiliary procedures were performed in 37.3% of the cases, including Double-J stent and ureteral catheter in 26.8%, ureterorenoscopy in 2.1%, percutaneous nephrostomy in 1.6%, Zeiss loop in 4.3% and percutaneous nephrolithotripsy in 3.5%. Of the treatments 83.1% were performed without general or regional anesthesia. Followup after 3 month…

Tumorspecific Antigens in Human Renal Cell Carcinoma: Ultrastructural Localization of the Antigen by Immune-Electron-Microscopy

In clinical oncology, tumor markers are a valuable tool in therapy monitoring of tumor patients as well as for primary diagnosis. In renal cell carcinoma a number of tumor associated antigens were described which may also be expressed in normal kidney epithelium (Bander et al. 1983; Bander 1984; Moon et al. 1982; Oosterwijk et al. 1987a, b; Ueda 1981). Only occasionally are antigens described which do not react in normal kidney tissue. The here described antigen is restricted to well differentiated human renal cell carcinoma (RCC) and does not show any expression in the normal kidney or other human organs (Table 1). The antibodies produced by hybridoma-technology are highly specific for the…

Karyotype analysis and marker chromosomes of renal cell carcinoma.

Karyotyping was performed in 46 human renal cell carcinomas of various histological grades. Controls included chromosome analysis of normal renal parenchymal cells from the same patients. Various numerical chromosome aberrations were found as well as marker chromosomes. They are specific of the individual tumor but no single marker was identified occurring in all tumors tested. Only trisomy 3 was found in different tumors (31%), suggesting a more general character of this aberration. Histological dedifferentiation and large tumor size correlate with focusing of the karyotype towards distinct chromosomal modes indicative of distinct tumor cell subclones within these tumors. Their rapid growt…

Therapeutische Alternativen beim fortgeschrittenen Nierentumor

Metastasierte Nieren-Carcinome stellen ein ungelostes therapeutisches Problem dar. Seit uber 20 Jahren werden in die Immuntherapie immer wieder Erwartungen gesetzt, die sich letztlich nicht erfullt haben. Die Liste immunologischer Therapieansatze ist lang und reicht von der BCG-Therapie bis zu den verschiedenen Interferonen. Damit konnten zwar in wenigen Fallen komplette Metastasenregressionen erzielt werden. Ein therapeutischer Durchbruch war es jedoch nicht.