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Tu Y, Yu P, Yu L, Ji H, Wan Y, Shi L, Chen A, Zhong F. A Rare Case of Metastatic Clear Cell Renal Cell Carcinoma to the Petroclival Region Presenting as Posterior Cranial Neuropathies. EAR, NOSE & THROAT JOURNAL 2023:1455613231182670. [PMID: 37568274 DOI: 10.1177/01455613231182670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
We present a case of metastatic renal cell carcinoma (RCC) to the petroclival region with clinical symptoms manifested as posterior cranial neuropathies. A 65-year-old male presented with headache symptom for over 1 year, during which time he was diagnosed with RCC and underwent right nephrectomy. However, the headache symptom and cranial neuropathies had been attributed to cranial neuritis all the time until the surgical removal of metastatic tumor in the petroclival region led to the diagnosis of metastatic RCC. RCC has a tendency for metastasis early. The incidence of spread of RCC to brain is a rarity in clinical practice. When a patient presents with cranial nerve neuropathies, the possibility of metastatic RCC should be sought. Brain metastases display nonspecific presentations, and it is useful to examine with magnetic resonance imaging and computed tomography scans radiologically.
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Affiliation(s)
- Yanyi Tu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Peng Yu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Liang Yu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hongzhi Ji
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuzhu Wan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li Shi
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Aiping Chen
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Feng Zhong
- Department of Nursing, Shandong Second Provincial General Hospital, Jinan, China
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[ 18F]FDG PET/CT: Lung Nodule Evaluation in Patients Affected by Renal Cell Carcinoma. Tomography 2023; 9:387-397. [PMID: 36828383 PMCID: PMC9962353 DOI: 10.3390/tomography9010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Renal Cell Carcinoma (RCC) is generally characterized by low-FDG avidity, and [18F]FDG-PET/CT is not recommended to stage the primary tumor. However, its role to assess metastases is still unclear. The aim of this study was to evaluate the diagnostic accuracy of [18F]FDG-PET/CT in correctly identifying RCC lung metastases using histology as the standard of truth. The records of 350 patients affected by RCC were retrospectively analyzed. The inclusion criteria were: (a) biopsy- or histologically proven RCC; (b) Computed Tomography (CT) evidence of at least one lung nodule; (c) [18F]FDG-PET/CT performed prior to lung surgery; (d) lung surgery with histological analysis of surgical specimens; (e) complete follow-up available. A per-lesion analysis was performed, and diagnostic accuracy was reported as sensitivity and specificity, using histology as the standard of truth. [18F]FDG-PET/CT semiquantitative parameters (Standardized Uptake Value [SUVmax], Metabolic Tumor Volume [MTV] and Total Lesion Glycolysis [TLG]) were collected for each lesion. Sixty-seven patients with a total of 107 lesions were included: lung metastases from RCC were detected in 57 cases (53.3%), while 50 lesions (46.7%) were related to other lung malignancies. Applying a cut-off of SUVmax ≥ 2, the sensitivity and the specificity of [18F]FDG-PET/CT in detecting RCC lung metastases were 33.3% (95% CI: 21.4-47.1%) and 26% (95%CI: 14.6-40.3%), respectively. Although the analysis demonstrated a suboptimal diagnostic accuracy of [18F]FDG-PET/CT in discriminating between lung metastases from RCC and other malignancies, a semiquantitative analysis that also includes volumetric parameters (MTV and TLG) could support the correct interpretation of [18F]FDG-PET/CT images.
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Čerškutė M, Kinčius M, Januškevičius T, Cicėnas S, Ulys A. Sternal resection of a solitary renal cell carcinoma metastasis: a case report and a literature review. Acta Med Litu 2018; 25:226-233. [PMID: 31308828 PMCID: PMC6591693 DOI: 10.6001/actamedica.v25i4.3933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 02/19/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) may be metastatic, although solitary sternal metastasis of RCC is a rare medical condition. Here we report an unusual case of a 63-year-old male with a solitary sternal metastasis as an initial presentation of clear-cell renal cell carcinoma. MATERIALS AND METHODS A 63-year-old male presented with a small sternal mass. Chest computer tomography (CT) and a biopsy from the sternal tumour were performed. Histopathological examination revealed the diagnosis of renal clear cell carcinoma metastasis to the sternal bone. On the basis of a subsequently performed abdominal CT the patient was confirmed with a suspicion of a left renal lower pole tumour. Treatment with sunitinib was initiated. Due to the limited response and a growing sternal mass, the patient was admitted to the National Cancer Institute after two cycles of sunitinib therapy. Open left partial nephrectomy was performed followed by the resection of the sternal metastasis two months later. The chest wall was reconstructed with polypropylene mesh combined with transversal rectus abdominis musculocutaneous flap. RESULTS The postoperative course after the partial nephrectomy was uneventful. The postoperative course of metastasectomy complicated with the right pneumothorax which was successfully treated by insertion of a chest tube. Bleeding from the upper digestive tract also occurred on the seventh postoperative day but was successfully controlled by haemostasis with three 20 ml endoscopic injections of 1:10,000 solution of epinephrine. The patient had been followed up after the surgery for 30 months with biannual chest and abdominal CT scans that showed neither local nor distant recurrence of the disease. CONCLUSIONS Radical surgical treatment of a solitary renal clear cell carcinoma metastasis may offer the best cancer-specific outcomes and improve the quality of life in some patients.
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Affiliation(s)
| | - Marius Kinčius
- Department of Onco-urology, National Cancer Institute, Vilnius, Lithuania
| | | | - Saulius Cicėnas
- Department of Thoracic Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Albertas Ulys
- Department of Onco-urology, National Cancer Institute, Vilnius, Lithuania
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Ganeshan D, Morani A, Ladha H, Bathala T, Kang H, Gupta S, Lalwani N, Kundra V. Staging, surveillance, and evaluation of response to therapy in renal cell carcinoma: role of MDCT. ACTA ACUST UNITED AC 2015; 39:66-85. [PMID: 24077815 DOI: 10.1007/s00261-013-0037-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Renal cell carcinoma is the most common malignant renal tumor in the adults. Significant advances have been made in the management of localized and advanced renal cell carcinoma. Surgery is the standard of care and accurate pre-operative staging based on imaging is critical in guiding appropriate patient management. Besides staging, imaging plays a key role in the post-operative surveillance and evaluation of response to systemic therapies. Both CT and MR are useful in the staging and follow up of renal cell carcinoma, but CT is more commonly used due to its lower costs and wider availability. In this article, we discuss and illustrate the role of multi-detector CT in pre-operative staging, post-operative surveillance, and evaluation of response to systemic therapy in renal cell carcinoma.
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Grassi P, Verzoni E, Porcu L, Testa I, Iacovelli R, Torri V, Braud FD, Procopio G. Targeted therapies in advanced renal cell carcinoma: the role of metastatic sites as a prognostic factor. Future Oncol 2015; 10:1361-72. [PMID: 25052747 DOI: 10.2217/fon.14.69] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIM This retrospective study evaluates whether metastatic sites were associated with progression-free survival (PFS) and overall survival (OS) in patients with renal cell carcinoma treated with targeted therapies. PATIENTS & METHODS In total, 358 patients were analyzed. RESULTS & CONCLUSION After a median follow-up of 56.1 months, median PFS was 11 months and median OS was 24.2 months. Metastatic sites were associated with PFS: lymph nodes (HR: 1.43; 95% CI: 1.12-1.83; p = 0.004), liver (HR: 1.41; 95% CI: 1.05-1.90; p = 0.021), bone (HR: 1.26; 95% CI: 0.96-1.65; p = 0.091), brain (HR: 0.81; 95% CI: 0.46-1.43; p = 0.474) and other sites (HR: 1.07; 95% CI: 0.83-1.38; p = 0.589). Metastatic sites were associated with OS: lymph nodes (HR: 1.73; 95% CI: 1.31-2.29; p < 0.001), liver (HR: 1.71; 95% CI: 1.23-2.37; p = 0.002), bone (HR: 1.48; 95% CI: 1.10-1.98; p = 0.009), brain (HR: 1.21; 95% CI: 0.64-2.28; p = 0.568) and other sites (HR: 1.09; 95% CI: 0.81-1.47; p = 0.568). Patients with >2 metastatic sites had shorter PFS and OS. Every association was lost when introducing the Motzer score in regression models.
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Affiliation(s)
- Paolo Grassi
- Medical Oncology 1, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, Italy
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Lee H, Hwang KH, Kim SG, Koh G, Kim JH. Can Initial (18)F-FDG PET-CT Imaging Give Information on Metastasis in Patients with Primary Renal Cell Carcinoma? Nucl Med Mol Imaging 2013; 48:144-52. [PMID: 24900155 PMCID: PMC4028476 DOI: 10.1007/s13139-013-0245-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 10/10/2013] [Accepted: 10/15/2013] [Indexed: 12/22/2022] Open
Abstract
Purpose The aim of this study was to investigate the relationship between the maximum standardized uptake values (SUVmax) of primary renal cancers with and without metastatic lesions, if any. We also studied the relationship between the size of primary renal cancers and their SUVmax, and tried to find a clinical value of 18F-FDG PET-CT for the initial evaluation of renal cell carcinoma (RCC). Methods The cases of 23 patients, 16 men and 7 women, who underwent PET-CT examination before operation were retrospectively reviewed. We measured the SUVmax of the primary renal cancers and those of any existing metastatic lesions, and the size of the primary renal cancers. We compared the SUVmax of primary RCCs with metastases and those without metastases, SUVmax of primary RCC and those of metastases, and studied the correlation between the size and SUVmax of primary RCCs. Results The SUVmax of primary RCC of the 16 patients without metastasis ranged from 1.1 to 5.6 with a median value of 2.6. Those of the patients with metastasis ranged from 2.9 to 7.6 with a median of 5.0. The size of the all 23 primary renal cancers ranged from 1.7 cm to 13.5 cm, with a median of 4.5 cm, and their SUVmax ranged from 1.1 to 7.6, with a median of 2.9. There was a statistically significant difference between the SUVmax of the primary RCC with metastasis (5.3 ± 1.7) and those without metastasis (2.9 ± 1.0). There was a moderate positive correlation between the sizes and SUVmax of all 23 primary RCCs. However, there was no statistically significant correlation between the sizes and SUVmax of primary RCCs with metastatic lesions and the same for RCCs without metastasis. The cutoff value of SUVmax for predicting extra-renal lesion was 4.4 and that for size was 5.8 cm according to the receiver operating characteristic curves. Conclusions Those who have primary RCC with high SUVmax are suggested to have a likelihood of metastasis. Also, there was a moderate trend of increasing value of SUVmax of primary RCC as their size increases. Physicians should beware of missing extra-renal lesions elsewhere.
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Affiliation(s)
- Haejun Lee
- Department of Nuclear Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Kyung Hoon Hwang
- Department of Nuclear Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Seog Gyun Kim
- Department of Nuclear Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Geon Koh
- Department of Nuclear Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Ji Hyun Kim
- Department of Nuclear Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
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Kramer MW, Merseburger AS, Peters I, Waalkes S, Kuczyk MA. [Systemic and surgical management of metastatic renal cell carcinoma]. Urologe A 2011; 51:217-25. [PMID: 22009257 DOI: 10.1007/s00120-011-2713-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several targeted therapies have become available for first-line (sunitinib, bevacizumab, pazopanib, temsirolimus) and second-line (sorafenib, pazopanib, everolimus) use in recent years. The superior outcomes achieved with these targeted agents have led to replacement of the formerly administered cytokines. New developments have raised the question of whether patients benefit from sequential therapies with tyrosine kinase inhibitors and/or whether combination regimes can improve clinical outcomes. This review gives an overview of the current therapeutic options for first- and second-line treatment in metastatic RCC as well as sequential and combination therapies. Adjuvant and neoadjuvant treatment options are being discussed. Furthermore, this review addresses surgical alternatives in the treatment of RCC.
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Affiliation(s)
- M W Kramer
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 Hannover, Deutschland
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Jain Y, Liew S, Taylor MB, Bonington SC. Is dual-phase abdominal CT necessary for the optimal detection of metastases from renal cell carcinoma? Clin Radiol 2011; 66:1055-9. [PMID: 21843882 DOI: 10.1016/j.crad.2011.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 05/25/2011] [Accepted: 06/06/2011] [Indexed: 11/28/2022]
Abstract
AIM To determine whether dual-phase abdominal computed tomography (CT) detected more metastases than portal-phase CT alone in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS Audit committee approval was obtained. A retrospective audit was undertaken in 100 patients who underwent both arterial and portal phase CT. The CT images were independently reviewed by two consultant radiologists. The presence of metastases in the liver, pancreas, and contralateral kidney were recorded for each phase of contrast enhancement. RESULTS Metastases were identified in the liver in 27 patients, pancreas in 12, and contralateral kidney in 23 patients. Nine of the 27 (33%) liver metastases, three of the 12 (25%) pancreatic metastases, and two of the 23 (9%) renal metastases were only detected in the arterial phase, whilst four of the 27 (15%) liver metastases, three of the 12 (25%) pancreatic metastases, and two of the 23 (9%) renal metastases were only detected in the portal phase. Nine patients (9%) had metastases only visualized in the arterial phase, and six (6%) only in the portal phase. Detection of metastases only visible in the arterial phase led to a change of management in two patients (2%). CONCLUSION The audit results support our current standard of dual-phase abdominal CT for optimal detection of RCC metastases.
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Affiliation(s)
- Y Jain
- The Christie NHS Foundation Trust, Manchester, UK.
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Griffin N, Grant LA, Bharwani N, Sohaib SA. Computed Tomography in Metastatic Renal Cell Carcinoma. Semin Ultrasound CT MR 2009; 30:359-66. [DOI: 10.1053/j.sult.2009.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Barbetakis N, Samanidis G, Paliouras D, Tsilikas C. eComment: surgery for pulmonary metastases of renal cell carcinoma. Video-assisted thoracoscopic or open procedure? Interact Cardiovasc Thorac Surg 2008; 7:828. [PMID: 18801808 DOI: 10.1510/icvts.2008.181065a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Antonelli A, Cunico SC. Surgery for renal carcinoma metastases. Urologia 2008. [DOI: 10.1177/039156030807500101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
During the last few years, the increasing use of diagnostic imaging (especially ultrasound) has allowed a remarkable rise in the detection of asymptomatic, early-stage renal neoplasms, possibly treatable by radical surgery. Renal cell carcinoma, however, is still the renal neoplastic condition with the highest mortality rate, due in most cases to the presence of distal metastases. Because of a lack of agreement on an efficient systemic therapeutic approach, surgery is generally considered to be the most suitable option to remove metastases: it is technically easy to perform, it can increase survival and the patient's psychological compliance, though metastasectomy is unlikely to cure the metastatic patient. In our experience, we studied 1475 patients who underwent surgery for renal cell carcinoma from 1983 on. 304 (20%) developed a metastasis; 4 subjects only (5.4%) out of the 74 having multiple metastatic anatomical sites were long-surviving. 39 subjects (16.9%) out of the 230 having single-site metastases are currently disease-free (mean follow-up: 80 months from diagnosis): 33 out of the 111 patients who underwent metastasectomy, 4 out of the 57 who received a medical therapy, 1 out of the 14 being administered radiotherapy, and 1 out of the 48 who were cared under palliative purposes only. Therefore we concluded that, in case of single-site (lung or adrenal) metastases, surgery is the most suitable and advisable therapeutic approach, being the only option able to achieve survival even for a small amount of patients. New biologic drugs are currently under investigation, which can interfere with tumor proliferation and angiogenesis: the study results are still preliminary, nevertheless these drugs open the way to a multimodal medical option of treatment for metastatic renal cell carcinoma.
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Affiliation(s)
- A. Antonelli
- Cattedra di Urologia, Università degli Studi di Brescia, Brescia
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Abstract
OBJECTIVE Metastatic disease occurs in a significant percentage of patients with renal cell carcinoma. Recent advances in systemic therapies for metastatic renal cell carcinoma are likely to have a significant effect on the way patients with advanced disease are imaged. These new therapies have shown a significant increase in progression-free survival. CONCLUSION Imaging is likely to play an increasing role in the management, diagnosis, and monitoring of response to treatment of metastatic renal cell carcinoma.
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Affiliation(s)
- Nyree Griffin
- Department of Diagnostic Imaging, Royal Marsden Hospital, 203 Fulham Rd., London SW3 6JJ, United Kingdom
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Thyavihally YB, Mahantshetty U, Chamarajanagar RS, Raibhattanavar SG, Tongaonkar HB. Management of renal cell carcinoma with solitary metastasis. World J Surg Oncol 2005; 3:48. [PMID: 16029517 PMCID: PMC1185571 DOI: 10.1186/1477-7819-3-48] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2004] [Accepted: 07/20/2005] [Indexed: 11/23/2022] Open
Abstract
Background Distant metastasis are common in Renal cell carcinoma (RCC) nearly one forth of the patients have metastasis at presentation while another 50% develop metastasis during the follow-up. A small percentage of these are solitary metastasis. We describe survival after surgical excision or radiotherapy of solitary metastatic lesion from renal cell carcinoma Patients and methods Between 1988–2001, 43 patients with solitary metastasis to different sites from renal cell carcinoma underwent either surgical excision or radiotherapy were analyzed. The solitary nature of the lesions was confirmed by investigations. All patients have had radical nephrectomy for the primary lesion. Survival analysis was carried out by Kaplan Meier Method. Results All solitary metastatic lesions were treated with intent of cure either by excision or radiotherapy. Of these, 13 patients had solitary metastasis at the time of presentation in whom 3-year overall median survival was 26 months. The survival of those who developed solitary metastases during follow-up after nephrectomy for primary was 45 months. The patients with long interval between diagnosis and development of metastasis, early stage and low grade of the primary tumor had better prognosis. Conclusion Complete resection of either synchronous or metachronous solitary metastases from renal cell carcinoma is justified and can contribute to a long-term survival in this select group of patients.
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Affiliation(s)
| | | | | | | | - Hemant B Tongaonkar
- Department of Genito-urinary oncology, Tata Memorial Hospital, Mumbai, India
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Patel AN, Lamb J, Patel N, Santos RS, Stavropoulos C, Landreneau RJ. Clinical trials for pulmonary metastasectomy. Semin Thorac Cardiovasc Surg 2003; 15:457-63. [PMID: 14710388 DOI: 10.1053/j.semtcvs.2003.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There remains great controversy as to the indications and true benefits for pulmonary metastasectomy. The number of metastatic lesions, length of disease-free interval, and unilaterality has shown to be important prognostic factors on overall survival. In this review, we evaluate a number of clinical trials and critically assess the rational to perform pulmonary metastasectomy, which is a local treatment for a systemic disease process.
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Affiliation(s)
- Amit N Patel
- Section of Thoracic Surgery, University of Pittsburgh Medical Center, PA 15213, USA
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de la Haba Rodríguez JR, Algar Algar J, Méndez Vidal MJ, Aranda IB, Alvarez Kindelan A, López Pujol J, Aguilar EA. Surgical treatment of pulmonary metastases: experience with 40 patients. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2002; 28:49-54. [PMID: 11869014 DOI: 10.1053/ejso.2001.1068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS Combinations of surgery and chemotherapy have a favourable impact on survival in the treatment of disseminated neoplastic disease isolated to the lung. Sample and technical factors have made the reproduction of the published results difficult. METHODS In this study we report experience over 10 years. RESULTS From 1989 to 1999 40 patients underwent metastasectomy. Thirty received chemotherapy. The median survival is 51 months, similar to other published series. CONCLUSION Survival benefit can be observed in small series of such cases.
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Homsi J, Walsh D, Nelson KA, LeGrand SB, Davis M. Hydrocodone for cough in advanced cancer. Am J Hosp Palliat Care 2000; 17:342-6. [PMID: 11886059 DOI: 10.1177/104990910001700512] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cough is a common symptom in advanced cancer. Hydrocodone is the antitussive of choice in our palliative medicine inpatient unit. We reviewed the pharmacy records for the use of hydrocodone for all cancer admissions to our unit from May 1996 to December 1998. Median treatment duration with hydrocodone was three days (range 1-18). Median maximum daily dose was 15 mg (range 5-100), and median total dose during the hospital stay was 32 mg (range 5-455). Lung cancer as a primary cancer site was strongly related to the use of hydrocodone. The highest median duration of treatment (five days) was for esophageal cancer and the highest median maximum daily dose (35 mg) and total dose (75 mg) were for treating kidney cancer. This retrospective review provides information regarding the use of hydrocodone on the palliative medicine unit of the Cleveland Clinic Foundation. Controlled trials are needed to evaluate the efficacy and safety of hydrocodone for cough in advanced cancer.
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Affiliation(s)
- J Homsi
- Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Center, Ohio, USA
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Stief CG, Jáhne J, Hagemann JH, Kuczyk M, Jonas U. Surgery for metachronous solitary liver metastases of renal cell carcinoma. J Urol 1997. [PMID: 9224306 DOI: 10.1016/s0022-5347(01)64483-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The postoperative outcome and survival of patients undergoing surgery for metachronous solitary liver metastases of renal cell carcinoma were evaluated. MATERIALS AND METHODS Between 1983 and 1993, 17 patients with metachronous liver metastases of renal cell carcinoma underwent laparotomy for metastatic liver disease. All patients had undergone radical nephrectomy a mean of 3.6 years before the diagnosis of liver metastases. RESULTS Surgical resection was feasible in 13 of 17 patients with right hemihepatectomy in 9 (3 multivisceral resections), wedge resection in 4 and ex situ (mobilization and eversion out of the abdomen) resection in 1. Stage R0 resection (complete removal, negative surgical margins with no macroscopic disease left behind) was possible in 11 of 13 cases (85%). In patients with metastatic liver tissue resection the mortality rate was 31% (4 of 13) with additional significant morbidity in another 2. Mean survival of patients with nonresectable disease was 4 months, which increased to 16 months after resection. CONCLUSIONS Complete resection of metachronous liver metastases can be achieved in the majority of patients. However, significant morbidity and mortality as well as the limited prognosis even after R0 resection strongly suggest careful patient selection.
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Affiliation(s)
- C G Stief
- Department of Urology, Medizinische Hochschule, Hannover, Germany
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Cunico SC, Cozzoli A, Pezzotti G, Zani D, Cancarini G, Sironi D, Da Pozzo G. Prognostic factors in metastatic renal cell carcinoma. Urologia 1997. [DOI: 10.1177/039156039706400209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
– One-third of patients with renal cell carcinoma present with metastatic desease, while 30-40% of the remainder will eventually develop distant metastases within 5 years after radical nephrectomy. The median survival for patients with metastastic RCC is less than 1 year. We report our experience on the treatment of metastatic RCC from 1983 to 1993.
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Affiliation(s)
| | - A. Cozzoli
- Divisione Clinicizzata di Urologia - Università di Brescia
| | - G. Pezzotti
- Divisione Clinicizzata di Urologia - Università di Brescia
| | - D. Zani
- Divisione Clinicizzata di Urologia - Università di Brescia
| | - G. Cancarini
- Divisione Clinicizzata di Urologia - Università di Brescia
| | - D. Sironi
- Divisione Clinicizzata di Urologia - Università di Brescia
| | - G.P. Da Pozzo
- Divisione Clinicizzata di Urologia - Università di Brescia
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Cozzoli A, Cancarini G, Cunico SC. Our experience in the surgical treatment of renal carcinoma metastases. Urologia 1996. [DOI: 10.1177/039156039606300411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors report their experience in the surgical treatment of synchronous and metachronous metastases from renal cell carcinoma. From January 1986 to December 1992, 47 nephrectomised patients (11.6%) out of 403 underwent contemporary or subsequent metastasectomy. Metastases were synchronous in 18 cases (38.3%), while metachronous metastases appeared in 29 (61.7%) after a mean disease-free interval of 28 months. After a mean follow-up of 36 months, out of the 18 cases with synchronous metastases, 9 died, 4 are in progression and 5 are still alive and NED; of the 29 patients with metachronous metastases, 3 died, 6 are in progression and 20 are still alive and NED. In conclusion, while the presence of synchronous metastases is an unfavourable prognostic factor even after their removal, results after surgery of metachronous metastases are encouraging.
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Affiliation(s)
- A. Cozzoli
- Divisione Clinicizzata di Urologia - Università di Brescia
| | - G. Cancarini
- Divisione Clinicizzata di Urologia - Università di Brescia
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