PTU - Polskie Towarzystwo Urologiczne
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CODE: 21 - Multiple pulmonary metastases complete remission in the course of advanced renal cell carcinoma
Article published in Urologia Polska 2006/59/Suplement 1.


Tomasz Syryło, Henryk Zieliński, Włodzimierz Chudzik, Jakub Żołnierek, Sylwia Oborska, Paweł Nurzyński, Cezary Szczylik
Klinika Urologii Wojskowego Instytutu Medycznego w Warszawie


Introduction and objectives. Natural history of renal cell carcinoma (RCC) varies significantly. In 30% of patients there is progression and metastatic disease at the time of diagnosis. The most common localization of RCC metastases are the lungs. Clinical course of RCC depends on interaction between host's immunological system and the tumor and it conditions chemoimmunotherapy treatment. The aim of the study is evaluation of pulmonary metastases remission in patients with advanced RCC.
Material and methods. From February 1998 to April 2003 54 patients were treated in our department of oncology with renal carcinoma diagnosis and pulmonary metastases. There was chemoimmunotherapy treatment used which was based on IL-2, INF-alfa and 5-FU. Study group included 10 women and 44 men in the age of 23-76 years. Performance status was evaluated using ECOG-scale. Primary tumor diagnosis was confirmed histopathologicaly. Before systemic treatment all patients had nephrectomy. In 9 (16.6%)of them renal artery embolisation was performed.
Results. In study group we observed 5 complete and 12 partial remissions. We noticed CR in 6 patients: 1 of them had CR after one chemoimmunotherapy course and 5 of them after two courses. Histological diagnosis described ca clarocellularae in 4 patients and ca claro-granulocellularae in 1 patient. PR was observed in 12 and 5 of them had pulmonary metastases.
Conclusions. 1. Nephrectomy should be performed before chemoimmunotherapy in these patients with metastatic RCC who are in good general condition. 2. Due to chemoimmunotherapy we obtained 5 CR which lasted for many months. 3. The patients with pulmonary metastases have the best results of this therapy.