5.15.11.agent orange and renal cancerDocument Transcript
EMBARGOED FOR RELEASE UNTIL May 14, 2011 AT 11:30 A.M. Contact: Wendy Waldsachs Isett, AUA 410-977-4770, wisett@AUAnet.org AGENT ORANGE LINKED TO RENAL CANCER Severity of renal cancer in patients exposed to Vietnam-era chemical is examinedWashington, DC, May 14, 2010–In recent years, the prevalence of renal cancer has increased, in partdue to the detection of tumors during imaging studies for non-related health concerns. While AgentOrange, a herbicide used during the Vietnam war, has been previously linked to a variety of types ofcancers in Vietnam veterans, new data from researchers at the Veterans Affairs Medical Center inShreveport, LA, indicates that there may be a connection between veterans’ in-country exposure andsubsequent development of renal cancer. The findings were presented to reporters during a specialpress conference at the Walter E. Washington Convention Center in Washington, DC on Sunday, May15 at 11:30 a.m. during the 106th Annual Scientific Meeting of the American Urological Association(AUA). The session will be moderated by Anthony Y. Smith, MD.Researchers at the Overton Brooks VAMC in Shreveport examined charts for 297 patients diagnosedwith renal cancer between 1987 and 2009. Of these patients, 13 (4 percent), ranging in age from 39 to63 years at time of presentation, claimed exposure to Agent Orange. Eleven of these patientsunderwent surgical treatment. Authors reviewed age at presentation, tumor size, side of lesion,pathology and survival in the 10 patients with documented exposure to Agent Orange for whichpathology reports were available.Of these patients, 90 percent had clear-cell cancers, which typically have a worse prognosis thanpapillary tumors, which appeared in one of the patients. One patient had combined clear-cell andpapillary cancers. Node sampling was negative in all. Mean follow up was 54 months. Four patientsdeveloped metastatic disease and one patient died from his cancer. “We know that the chemicals in Agent Orange were extremely toxic, and are known to cause cancer,”Dr. Smith said. These data indicate that we may need to better determine whether exposure to thesechemicals should be considered a risk factor for kidney cancer.”About Agent Orange: Agent Orange is a combination of two synthetic compounds known to becontaminated with the dioxin tetrachlorodibenzo-para-dioxin (TCDD) during the manufacturingprocess. Named for the color of the barrel in which it was stored, Agent Orange was one of many
broad-leaf defoliants used in Vietnam to destroy enemy ground cover. It is estimated that more than20 million gallons of the chemicals, also known as “rainbow herbicides” were used between 1962 and1971; approximately half the herbicides were Agent Orange. In 1997, the International Agency forResearch on Cancer re-classified TCDD as a Group 1 carcinogen, a classification that includes arsenic,asbestos and gamma radiation.NOTE TO REPORTERS: Experts are available to discuss this study outside normal briefing times. Toarrange an interview with an expert, please contact the AUA Communications Office at the numberabove or e-mail wisett@AUAnet.org.About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, theAmerican Urological Association is the pre-eminent professional organization for urologists, with more than17,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission offostering the highest standards of urologic care by carrying out a wide variety of programs for members and theirpatients. ###
529: OVERTON BROOKS VAMC PRELIMINARY FINDINGS IN PATIENTS EXPOSED TO AGENT ORANGEWITH RENAL CELL CANCERAyme Schmeeckle, Deborah Moore, Robert Moore, Phillip Hadaad, Shreveport, LA INTRODUCTION AND OBJECTIVES: The effect of Agent Orange (AO) on the human body has remaineda topic of controversy in medical literature over the last forty years. Previous studies havedocumented increased risks of several different cancers in those exposed. There have been no studiesto date reviewing renal cell cancer in patients exposed to AO. The purpose of this study was to reviewthe characteristics of renal cell cancer in patients exposed to Agent Orange.METHODS: A retrospective chart review was performed from 1987 to 2009 of all patients diagnosedwith renal cell cancer (RCC) at Overton Brooks VAMC in Shreveport, Louisiana. We specificallyreviewed age of presentation, tumor size, side of lesion, pathology and survival in patients withdocumented exposure to AO.RESULTS: 297 patients were diagnosed with renal cell cancer over a period of 22 years. Thirteenpatients (4%) claimed exposure to Agent Orange. The average age of presentation was 56.5 years(range 39-63). Eleven of the 13 AO patients were treated surgically. Of these 11 patients treatedsurgically, nine presented with T1 lesions; one with T2. Six lesions were left sided. Size ranged from2.5-5.5 cm in the T1 group. The T2 lesion measured 12cm. Pathology was clear cell in eight, combinedclear cell and papillary in one, and pure papillary in one. Pathology was unavailable in one patient.Three had nodal sampling at the time of surgery including the patient with T2 disease, and all nodessampled were negative. Mean follow-up was 54 months (range 4-168). Four patients developedmetastatic disease. Their mean age was 50.3 years (range 39-59). One patient died of his disease. Ofthe remaining two patients, one died of concurrent large cell lymphoma and the other of perforateddiverticulitis.
Size Follow Up Age T N Side Surgery Pathology Grade Outcomes (cm) (months) Open Lung metastasis at 8 years. Died of 44 5 1b L Clear cell 1 91 nephrectomy large cell lymphoma. Open partial 54 3.5 1a L Clear cell 2 93 No evidence of disease. nephrectomy Laparoscopic Brain metastasis at 3 years. Died of 59 5.3 1b L Clear cell 3 42 nephrectomy perforated diverticulitis. Laparoscopic 58 2.5 1a R Clear cell 2 64 No evidence of disease nephrectomy Laparoscopic 63 4 1a R Clear cell 2 56 No evidence of disease. nephrectomy Open Occipital metastasis at 10 months. XRT. 59 12 2 0/15 R Clear cell 3 44 nephrectomy Currently on sunitinib. Presented with lung and liver Open 39 R 168 metastasis at 23 years. Failed sunitinib. nephrectomy Died of respiratory failure. Laparoscopic 58 3.8 1a 0/5 L Clear cell 2 32 No evidence of disease. nephrectomy Open partial Clear cell, Surveillance of 1cm contralateral 59 3 1a L 2 19 nephrectomy papillary lesion. Laparoscopic 60 5.5 1b 0/3 L Papillary 3 4 No evidence of disease. nephrectomy Laparoscopic 61 6 1b R Clear cell 3 1 No evidence of disease. nephrectomyCONCLUSIONS: 40% of the patients exposed to AO progressed to metastatic disease and in apopulation with an average age of 50. Further data is being collected from other VA medical centers tofurther investigate if there is a link between renal cell cancer and Agent Orange exposure.Source of Funding: None