Kidney cancer: a genetic test to determine the risk of recurrence

The main function of the kidneys is to filter the blood in order to remove water, impurities and waste products.

Analyzing the genetic mutations present in kidney cancer tumors makes it possible to more accurately assess a patient's risk of recurrence, shows an international study in which researcher Yasser Riazalhosseini of McGill University.

Our work reveals that we may be able to better assess individual risk by studying the genetic mutations present in cancerous tissue, summarizes Riazalhosseini in a press release published by McGill.

• About 400,000 people are diagnosed with kidney cancer worldwide each year.
• More than 8,100 Canadians are diagnosed with kidney cancer each year and 1,950 die from it.
• About 30% of kidney cancers not metastatic may recur after surgery.

The analysis of mutations by DNA sequencing is already a widespread practice in other types of cancers. It could also be done for people with kidney cancer, thinks Yasser Riazalhosseini.

To get there one day, the researcher and 43 colleagues from 23 institutions in Europe and of Canada studied changes in the DNA of more than 900 kidney cancer samples removed during surgeries.

After dividing the patients into four groups based on the presence of mutations in 12 particular genes, the researchers followed them to find out if they had had cancer recurrences.

En Briefly, the results show that:

• In one group, as many as 91% of people were free of recurrence five years after surgery.
• In another of the groups, the percentage of people free of recurrence after five years was much lower, at 51%.

The authors of this work published in the journal Clinical Cancer Research (in English) believe that DNA sequencing will one day make it possible to establish with precision the risk of recurrence of breast cancer.

In the case of the first group mentioned above Above, sequencing would avoid unnecessary treatments for the patient, while it would allow them to be intensified for those in the second group.

Currently, to assess the risk of recurrence of kidney cancer, oncologists base themselves on certain characteristics, such as the size of the tumor and its apparent aggressiveness on microscopic examination, notes the McGill press release.

The arrival of more precise evaluation techniques is therefore welcome and will make it possible to refine treatments. It will also make it possible to establish the frequency of visits to the doctor according to the patient's DNA profile, but also to determine whether immunotherapy treatment is necessary since its effectiveness has been shown to reduce the risk of recurrence, but it presents side effects.

Rather silent in the early stages, kidney cancer is often discovered by chance during a medical examination carried out for another reason. In other cases, it can be revealed by symptoms (blood in the urine, back pain, swelling of the legs, etc.) or by the discovery of metastases.

Several factors increase the risk of this cancer, the main ones being smoking, being overweight and dialysis treatment for more than three years.