Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

EBUS-TBNA guides need for further treatment in RCC

Val-Bernal J et al. Pathology Research and Practice 2018; 214 (7), 949-56.

Key clinical point: Minimally invasive cytology sampling of mediastinal lymph nodes using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is useful for evaluation of mediastinal lymphadenopathy and determining the need for further treatment in patients with a previous diagnosis of renal cell carcinoma (RCC).

Major finding: Sixteen patients (15 males, mean age 59 years, range 44–81 years) were diagnosed by cytological and cell block study to have metastatic clear cell RCC. Twelve patients had been diagnosed with clear cell RCC in the past (mean 39 months, range 4–89 months) while in four, the tumor was primarily diagnosed in the staging phase on the basis of EBUS-TBNA. The EBUS features of the mediastinal nodal masses included increase of size (mean 2.5 cm, range 1.6–3.8 cm), irregular, inhomogeneous, hypervascular, and hyperechoic echotexture.

Study details: Examination of 1744 EBUS-TBNA studies of mediastinal and hilar lymph nodes performed for a variety of clinical indications including mediastinal malignancy.

Disclosures: The authors had no relevant financial disclosures.

Source: Val-Bernal J et al. Pathology Research and Practice 2018; 214 (7), 949-56.

Citation:

Val-Bernal J et al. Pathology Research and Practice 2018; 214 (7), 949-56.

This Week's Must Reads

CMS freezing of risk adjustment payments predicted to drive up insurance premiums, United States District Court Ruling Puts Risk Adjustment On Hold

If confirmed as Supreme Court justice, Kavanaugh could upend ACA, Case references, including Seven-Sky v. Holder

Software boosts accuracy of colonoscopies, Tripathi PV et al. DDW 2018 (Digestive Disease Week, 2018). Presentation 133.

Proposed fee schedule for 2019 could cut EHR hours, https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14985.pdf

Must Reads in Renal Cell Carcinoma

EBUS-TBNA guides need for further treatment in RCC, Val-Bernal J et al. Pathology Research and Practice 2018; 214 (7), 949-56.

Clear cell papillary RCC distinguished by unique staining pattern, Wang Y et al. Annals of Diagnostic Pathology 36: 2018; 1-4. https://doi.org/10.1016/j.anndiagpath.2018.06.007

Myelodysplasia risk high in RCC patients, Shenoy N et al. Clinical Genitourinary Cancer, Published online June 28, 2018. https://doi.org/10.1016/j.clgc.2018.06.008

Pembrolizumab in advanced clear cell RCC, McDermott DF et al. ASCO 2018 (annual meeting of the American Society of Clinical Oncology), Abstract 4500.

Do docetaxel nanoparticles boost response in mCRPC?, Autio KA et al. JAMA Oncol. 2018 July 5. doi: 10.1001/jamaoncol.2018.2168.