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PubMedDate not supplied

Impact of zoledronic acid on renal function in patients with cancer: Clinical significance and development of a predictive model.

Zoledronic acid is a potent bisphosphonate licensed for the treatment of myeloma and bone metastases from solid tumors. Renal deterioration is the most significant toxicity associated with zoledronic acid. We attempted to define the incidence and clinical significance of renal deterioration in patients receiving zoledronic acid and to develop a risk-factor profile for this treatment sequela. This study is a retrospective analysis of all patients who received zoledronic acid at Fox Chase Cancer Center, Philadelphia, Pa, between 1/10/02 and 1/30/04. Data recorded included patient demographics, tumor characteristics, comorbid illnesses, concomitant medications, cancer therapy, number of zoledronic acid doses administered, and serial creatinine measurements. In total, 3,115 evaluable doses of zoledronic acid were administered to 446 patients (median, 4 doses; mean, 6.98 doses; range, 1-28 doses) at a dose of 4 mg over 15 minutes every 3-4 weeks. Of these 446 patients, 42 experienced renal deterioration (median rise in creatinine level, 1.0 mg/dL; range, 0.5-4.4 mg/dL), requiring discontinuation of zoledronic acid therapy in 8 cases. No patient required dialysis and no patient died as a result of zoledronic acid-induced renal dysfunction. On multivariable analysis, predictive factors for the development of renal deterioration were patient age, a diagnosis of myeloma or renal cell cancer, cumulative number of doses, concomitant therapy with a nonsteroidal anti-inflammatory drug, and current or prior therapy with cisplatin. Using these factors, we constructed a predictive model with an area under the receiver operating characteristic curve of 0.75. The incidence of clinically significant renal deterioration in patients treated with zoledronic acid is low.We present a predictive model for decision support when estimating this risk.

Acute Kidney Injury↗
PubMed1965

SKIN CANCER AS A CAUSE OF DEATH.

An estimated 6,000 new cases of skin cancer (excluding melanoma) occur each year in California, and vital statistics data show about 125 deaths attributed annually to this cause. A study of deaths attributed to skin cancer indicates that the true number was probably between 40 and 50. More than half of those who died were 75 years of age or over. Delay by the patient was the factor occurring most often in the deaths which could have been avoided.

California↗
PubMed2003

Incidence of cytokeratin 20 expressed cells in primitive follicular structure and secondary neoplastic proliferations of nevus sebaceus.

BACKGROUND: Nevus sebaceus of Jadassohn (NSJ) is a complex hamartoma in which various kinds of secondary neoplastic or hyperplastic proliferations such as primitive follicular structure (PFS) may arise. Recently, cytokeratin (CK) 20 expressed cells in PFSs and trichoblastomas of NSJs were demonstrated. OBJECTIVE: To clarify the nature and relationship among these proliferations, those in other secondary neoplasms and precise CK distributions in such lesional epidermis are examined. METHODS: 49 cases of NSJ were analyzed clinicopathologically and immunohistochemically using ten monoclonal antibodies against involucrin and CKs. RESULTS: 15 of 49 cases possessed PFSs, and six cases, of which five were associated with PFSs, possessed seven lesions of secondary neoplasms: four BCC, two syringocystadenoma papilliferum (SAP) and one trichilemmoma. The age distribution of 15 patients with PFSs was significantly higher than that of the other 34 patients without the PFSs. The six patients with secondary neoplasms were statistically situated in a higher age range than the ten cases with the PFSs alone. Although the CK expression in lesional epidermis of NSJs were similar to that of normal epidermis, CK20 expressed cells were scattered in the PFSs of 11 cases among the 15 NSJs, but not in the other four cases. Three of the four cases were associated with BCC in which CK20 was not expressed. CONCLUSIONS: From the statistical analysis, we presumed that the existence of the PFSs indicates potency to develop secondary neoplasms. Moreover, the absence of CK20 expressed cells (Merkel cells) in the structures was speculated to predict the development of BCC in the future.

Adolescent↗