CODE: 21 - Multiple pulmonary metastases complete remission in course of advanced renal cell carcinoma after renal artery embolisation, nephrectomy and adjuvant immunochemotherapy
Article published in Urologia Polska 2006/59/Suplement 1.
Tomasz Syryło 1, Henryk Zieliński 1, Włodzimierz Chudzik 1, Jacek Anusik 1, Grzegorz Piotrowicz 1, Paweł Nurzyński 1, Magdalena Zagrodzka 2, Bernard Jaroń 1
- 1 Klinika Urologii, Wojskowy Instytut Medyczny w Warszawie
2 Zakład Onkologii, Wojskowy Instytut Medyczny w Warszawie
- Introduction. Natural history renal cell carcinoma (RCC) is very varied. In 30% of patients there is progression and metastatic disease at the time of diagnosis. Metastatic RCC has a poor prognosis with a median overall survival of about 12 months.
- Objectives. Evaluation of the results of treatment of a woman with advanced RCC, who revaled artery embolisation, radical nephrectomy and adjuvant immunochemotherapy.
- Materials and methods. 56-years old woman, in a good general condition, was admitted to our department for an incidental tumor of the right kidney (diam. 74 x 64mm) which was detecting using transabdominal ultrasonography and synchronous multiple pulmonary metastases confirmed by computed tomography (in the number of 25). Before surgical treatment right renal artery embolisation was performed. Two weeks after nephrectomy in Department of Oncology the patient was qualified for immunochemotherapy (according to Azpodien protocol) using interleukin - 2 and interferon-alpha subcutaneusly in combination with intravenous 5 - fluorouracil.
- Results. After two 8 - weeks treatment cycles the number of lung metastases decreased to 9 and after 4 cycles complete remission multiple pulmonary metastases was confirmed. Tolerance of treatment was good and acceptable. 15 months after nephrectomy focal metastatic lesion in right parietal lobe was diagnosed by computed tomography. The patient was qualified for neurosurgical treatment: cranyotomy with metastasectomy. She is now well, without complaints and remains under careful observation.
- Conclusions. In carefully selected cases combined treatment (renal artery embolisation, nephrectomy and immunochemotherapy) can be on effective method of treatment metastatic renal cell carcinoma.