Neoadjuvant temsirolimus in high-risk renal cell carcinoma: Results from a single-center prospective study.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 387-387
Author(s):  
A. A. Sheikh ◽  
A. Gharajeh ◽  
S. J. Hotte ◽  
J. H. Pinthus ◽  
A. Kapoor
Keyword(s):  
Renal Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Renal Mass ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Post Surgery

387 Background: The current first-line treatment for advanced renal cell carcinoma (RCC) includes targeted therapy with or without cytoreductive radical nephrectomy. There is a paucity of data as to the effectiveness of adjuvant and neoadjuvant treatment before radical nephrectomy for localized high-risk or advanced disease. We initiated a trial of neoadjuvant Temsirolimus before radical nephrectomy for locally advanced and metastatic RCC examining tumor response and survival. Methods: Patients who presented with advanced RCC were offered enrolment into a prospective, single-centre, ethics approved trial with 12 weeks of temsirolimus before radical nephrectomy. Biopsy tissue was obtained at enrollment and at time of cytoreductive nephrectomy for diagnosis. Patients were administered 25 mg in temsirolimus on a weekly basis for 12 weeks, and then underwent radical nephrectomy. Computed tomography scans and biomarkers were obtained on enrolment, 6 weeks and 12 weeks (before nephrectomy). Ongoing outcome and survival data were analyzed. Results: Eight patients were enrolled into the trial. Patient #1 (10-cm renal mass with bulky adenopathy T2N2M0) had no evidence of disease (NED) at 6 months post-nephrectomy. Patient #2 (9-cm renal mass, bulky adenopathy, pulmonary metastases T2N2M1) also had NED at 6 months postnephrectomy. Patients #3 and #4 experienced regression of the primary mass and have recently undergone uneventful surgery with follow-up pending. Patients #5 and #6 expired prior to the full course of therapy, but had diagnoses other than RCC. Patient #7 experienced disease progression, however, this patient's nephrectomy was delayed by 3 months due to an unrelated myocardial infarct. Patient #8 experienced adverse events. Conclusions: Our findings suggest that neoadjuvant temsirolimus before radical nephrectomy for advanced RCC may improve disease regression post-surgery, and may lead to disease resolution in patients with low-volume disease. Randomized studies with longer term follow-up is necessary to assess overall progression-free survival and overall survival. [Table: see text]

scholarly journals Safety and oncological outcomes for large (stage ≥T2b) and locally advanced renal cell carcinoma: comparison between laparoscopic and modified hand-assisted laparoscopic radical nephrectomy

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096123
Author(s):  
Xudong Guo ◽  
Hanbo Wang ◽  
Yuzhu Xiang ◽  
Xunbo Jin ◽  
Shaobo Jiang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Renal Tumors ◽  
Advanced Renal Cell Carcinoma ◽  
Operative Duration ◽  
Laparoscopic Radical Nephrectomy

Objective To compare the operative and oncologic outcomes between hand-assisted laparoscopic radical nephrectomy (HALRN) and laparoscopic radical nephrectomy (LRN) for large (stage ≥T2b) and locally advanced renal cell carcinoma. Methods We retrospectively collected data from patients who underwent HALRN or LRN for stage ≥T2b renal cell carcinoma from January 2011 to January 2018 in our institution. The patients’ demographics, perioperative parameters, and postoperative follow-up data were compared between the two groups. The survival outcome was estimated using the Kaplan–Meier method. Results The HALRN group comprised 78 patients, and the LRN group comprised 63 patients. The median operative duration was significantly shorter in the HALRN than LRN group. The two groups were equivalent in terms of the incision length, blood loss, complication rate, and duration of hospitalization. In the HALRN and LRN groups, the 5-year overall survival rates were 69.4% and 73.1%, the 5-year cancer-specific survival rates were 80.0% and 83.3%, and the 5-year progression-free survival rates were 66.4% and 74.7%, respectively, with no significant differences. Conclusions Compared with LRN, HALRN may offer a shorter operative duration and equivalent surgical outcomes without sacrificing oncological efficacy. In addition, HALRN has specific advantages for extremely large and complicated renal tumors.

Solitary Liver Metastasis of Renal Cell Carcinoma 8 Years After Nephrectomy

2021 ◽  
Author(s):  
Haoran Lu ◽  
Shouye Zhao ◽  
Guodong Ma ◽  
Rou Zhao ◽  
Bin Zhang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Renal Carcinoma ◽  
Pet Ct ◽  
Solitary Liver ◽  
Solitary Metastases

Abstract Background: Renal cell carcinoma (RCC) is the most common renal malignancy in adults. RCC can metastasize to various organs of the human body, including lung, bone, brain, liver, and adrenal gland. However, solitary metastases are relatively rare in clinical practice, and surgical treatment is still the preferred treatment.Case report: We present a 68-year-old male patient who was performed laparoscopic radical left nephrectomy for RCC 8 years ago. Postoperative routine examination revealed an occupying lesion in the liver. Further PET-CT suggested hepatic metastasis of RCC thus undergoing laparoscopic left hepatectomy. Pathology confirmed metastatic RCC in the liver. The patient recovered well after the operation, and there was no sign of recurrence during the follow-up for six months after the operation.Conclusion: Patients with renal carcinoma can still have recurrence and metastasis after radical nephrectomy for many years. Therefore, long-term close follow-up is beneficial to patients with radical nephrectomy.

scholarly journals Follow-up guidelines after radical or partial nephrectomy for localized and locally advanced renal cell carcinoma

2013 ◽  
Vol 3 (1) ◽  
pp. 73 ◽  
Author(s):  
Wassim Kassouf ◽  
Robert Siemens ◽  
Christopher Morash ◽  
Louis Lacombe ◽  
Michael Jewett ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Locally Advanced ◽  
Advanced Renal Cell Carcinoma

Prognostic factors for the recurrence of renal cell carcinoma after radical nephrectomy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14629-14629
Author(s):  
C. H. Ohlmann ◽  
T. Schneider ◽  
S. Wille ◽  
U. Engelmann ◽  
A. Heidenreich
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Prognostic Significance ◽  
Flank Pain ◽  
Time Of Surgery ◽  
Asymptomatic Patients

14629 Background: Recurrence of renal cell carcinoma depends mainly on tumor stage at the time of radical nephrectomy and increases with increasing T-stage. Up to 30% of patients with T1–2 tumors will experience local or distant recurrence. Recommendations for the follow-up include chest x-ray every 6 months for stages T1–4 and abdominal CT-scan for pT3–4 for the first 3 years. The aim of our study was to identify prognostic factors predicting recurrence of RCC in order to individualize follow up strategies. Methods: We retrospectively analyzed the charts of 177 patients with RCC who underwent radical nephrectomy. In 163/177 (92%) of the patients the histology revealed renal cell carcinoma. The median-follow up was 4.5 (1–6) years. The prognostic significance of histology, gender, age, c-reactive protein, hemoglobin, hematuria, gross hematuria, weight loss, flank pain and metastases at the time of surgery for risk of recurrence was calculated by uni- and multivariate analysis. Cancer specific survival (CSS) was analyzed by the Kaplan-Meir method. Results: Logistic regression analysis identified presence of metastases at time of surgery (p ≤ 0.0005), hematuria (p ≤ 0.0005) and flank pain (p = 0.011) as independent prognostic factors for the recurrence of RCC. The risk of recurrent disease is 33.5% with one, 70 to 83% with two and 95.6% with the presence of all 3 markers. 3-year CSS is 69% vs. 82% in symptomatic vs. asymptomatic patients (p = 0.1352), 45% vs. 90% in M1/N1 vs. M0/N0 (p = 0.0001) and 78% vs. 88% in pT3b vs. <pT3b (p = 0.0102). Conclusions: In our study we were able to identify prognostic factors for the recurrence of renal cell carcinoma. Based on this model the follow-up of patients can be individualized according to the risk for recurrence after radical nephrectomy. No significant financial relationships to disclose.

Oncologic and functional outcomes of radical and partial nephrecotmy in PT3A patholigically upstaged renal cell carcinoma: A multi-instituitional analysis.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 685-685 ◽  
Author(s):  
Madhumitha Reddy ◽  
Ahmet Bindayi ◽  
Zachary Hamilton ◽  
Stephen Ryan ◽  
Kendrick Yim ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Functional Outcomes ◽  
Locally Advanced ◽  
Positive Margin ◽  
Standard Of Care ◽  
Oncologic Outcomes ◽  
Functional Benefit

685 Background: Radical Nephrectomy (RN) has been the standard of care for complex and locally advanced renal cell carcinoma (RCC). Efficacy of PN in the setting of pT3a pathologic upstaged disease is controversial. We compared oncologic and functional outcomes of RN and PN in patients with upstaged pT3a RCC. Methods: Multicenter retrospective analysis of patients with cT1−2N0M0 RCC undergoing RN or PN upstaged to pT3a postoperatively. Primary outcome was Overall Survival (OS), with secondary outcomes being Recurrence Free Survival (RFS) and eGFR < 60 at last follow-up. Results: 8185 patients were analyzed (mean follow up 48 months). 945 (11.5%) were upstaged to pT3a [686 (72.6%) RN, 243 (25.7%) PN]. Logistic regression analysis showed that increasing age, decreasing BMI, increasing intraoperative EBL, and positive margin increased the OR of all-cause mortality (all p < 0.05, Table). Kaplan Meier analysis (KMA) revealed 5−year OS for PN cT1→pT3a, RN cT1→pT3a, PN cT2→pT3a, RN cT2→pT3a of 64%, 65.2%, 56.4% and 55.2% respectively (p = 0.059). KMA revealed 5−year RFS for PN cT1→pT3a, RN cT1→pT3a, PN cT2→pT3a, RN cT2→pT3a of 79%, 74%, 70% and 51% respectively (p < 0.001). PN was associated with a decreased risk of GFR < 60 at follow up (39.6% vs. 59.5% for RN, p = 0.008) Conclusions: PN did not adversely affect oncologic outcomes in select patients who are upstaged to pT3a RCC from cT1 or cT2 disease, and may provide renal functional benefit. Improvements with respect to RFS for PN are most likely driven by selection bias. [Table: see text]

Radiologic follow-up of patients with T1–3a,b,c or T4N+M0 renal cell carcinoma after radical nephrectomy

Urology ◽  
1998 ◽  
Vol 52 (6) ◽  
pp. 1000-1003 ◽  
Author(s):  
James A. Saidi ◽  
Jeffrey H. Newhouse ◽  
Ihor S. Sawczuk
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy
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