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The Impact of Tumor Eco-Evolution in Renal Cell Carcinoma Sampling

FISABIO Foundation, 46020 Valencia, Spain
Department of Health Sciences, European University of Valencia, Laureate Universities, 46023 Valencia, Spain
Department of Pathology, Cruces University Hospital, Biomarkers in Cancer Unit, Biocruces-Bizkaia Health Research Institute, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain
Department of Medical-Surgical Specialties, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
Author to whom correspondence should be addressed.
Cancers 2018, 10(12), 485;
Received: 5 November 2018 / Revised: 29 November 2018 / Accepted: 30 November 2018 / Published: 4 December 2018
(This article belongs to the Special Issue Metastatic Progression and Tumour Heterogeneity)
PDF [4113 KB, uploaded 4 December 2018]
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Malignant tumors behave dynamically as cell communities governed by ecological principles. Massive sequencing tools are unveiling the true dimension of the heterogeneity of these communities along their evolution in most human neoplasms, clear cell renal cell carcinomas (CCRCC) included. Although initially thought to be purely stochastic processes, very recent genomic analyses have shown that temporal tumor evolution in CCRCC may follow some deterministic pathways that give rise to different clones and sub-clones randomly spatially distributed across the tumor. This fact makes each case unique, unrepeatable and unpredictable. Precise and complete molecular information is crucial for patients with cancer since it may help in establishing a personalized therapy. Intratumor heterogeneity (ITH) detection relies on the correctness of tumor sampling and this is part of the pathologist’s daily work. International protocols for tumor sampling are insufficient today. They were conceived decades ago, when ITH was not an issue, and have remained unchanged until now. Noteworthy, an alternative and more efficient sampling method for detecting ITH has been developed recently. This new method, called multisite tumor sampling (MSTS), is specifically addressed to large tumors that are impossible to be totally sampled, and represent an opportunity to improve ITH detection without extra costs. View Full-Text
Keywords: clear cell renal cell carcinoma; tumor evolution; tumor ecology; intratumor heterogeneity; multisite tumor sampling; targeted therapy clear cell renal cell carcinoma; tumor evolution; tumor ecology; intratumor heterogeneity; multisite tumor sampling; targeted therapy

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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López-Fernández, E.; López, J.I. The Impact of Tumor Eco-Evolution in Renal Cell Carcinoma Sampling. Cancers 2018, 10, 485.

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