PTU - Polskie Towarzystwo Urologiczne
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The management in patients with kidney tumors and metastatic pathological fractures and independing fractures of the long bones
Article published in Urologia Polska 2002/55/4.

authors

Roman Król
Oddział Kliniczny Ortopedii i Traumatologii Narządu Ruchu Specjalistycznego Szpitala w Szczecinic-Zdunowie Kierownik oddziału: dr hab. Roman Król

keywords

kidney, renal carcinoma, metastases, pathological fractures, treatment

summary

Aim of the study. Tire results of surgical treatment of metastatic pathological fractures and independing fracture of the long bones in 16 renal cell carcinoma patients are presented. It concerns femoral bone in nine patients, tibial bone in one patient, and humeral bone-in six patients.
Material and method. Our group of patients consisted of seven women and nine men, aged from 37 to 68 years. The follow-up time was from 3 to 48 months. In six patients bone metastasis was the first symptom of renal cancer, and in ten patients osseous metastasis was diagnosed from 13 to 69 months after surgical removal of primary kidney tumor.
The surgical treatment consisted of resection of the metastatic region, insertion of cement filling with 2.0 g of the methotrexate into the bone defect, and stable bone fixation or implantation of the endoprosthesis. Two patients underwent two operations, 1 patient three operations, and 13 patients one operation. In all patients fixation of the pathological fracture and independing fracture of the long bone were stable.
In eight patients with metastatic lesion of the lower extremity the surgical treatment permits leave the bed and move with the crutches. In
six patients, who underwent an operation of the humeral bone, osseous stabilization and cement filling with the methotrexate made possible a normal function of the upper limb.
Results. During the follow-up, the mean survive time of the whole group of 16 patients was 39 months. In six patients, in whom osseous metastasis was the first symptom of renal cell carcinoma, meaii survive time was 24 months. In six patients with multiple metastases mean survive time was 12 months. In patients who underwent Iwo or three operations the mean survive time was 31 months. The longest mean survive time (42 months) was observed in patients, in whom osseous metastatic lesion was diagnosed a long time after removal of primary kidney tumor.
We did not observe postoperative complications nor systematic or local adverse events of the use of methotrexate in the cement filling.

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correspondence

Roman Król
Spółdzielcza 2
71-393 Szczecin
Ki: (0-91) 422-31-20