Open AccessNine-year survival after iterative metastasectomies for renal cell carcinoma
Author(s) -
Tiago Oliveira,
Adama Ouattara,
Wouter Everaerts,
Gert De Meerleer,
Steven Joniau
Publication year - 2019
Publication title -
urology annals
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.355
H-Index - 20
eISSN - 0974-7834
pISSN - 0974-7796
DOI - 10.4103/ua.ua_53_18
Subject(s) - medicine , metastasectomy , nephrectomy , renal cell carcinoma , sunitinib , surgery , lymph node , retroperitoneal lymph node dissection , radiology , metastasis , urology , cancer , oncology , chemotherapy , kidney , testicular cancer
We report the case of a 24-year-old male, diagnosed with an incidental T3a papillary renal cell carcinoma (RCC), treated with left laparoscopic radical nephrectomy. After 7 months, nodal recurrence was identified and retroperitoneal lymph node dissection (RPLND) was performed. Four months later, due to local recurrence, the patient underwent salvage RPLND, partial psoas resection and left adrenalectomy, and remained without recurrence during the following 15 months, after which treatment with sunitinib was started due to multiple metastases in pelvic lymph nodes, lungs, and bone. After 4 years of stable disease, progression at the quadratus lumborum and psoas muscles led to subsequent metastasectomy. No evidence of progression was identified for 2 years, after which, despite multimodal treatment (axitinib and radiotherapy to bone lesions), widespread disease progression led to patient death. This uncommon case of prolonged survival with metastatic RCC highlights the possible role of iterative metastasectomies in the management of advanced stage disease, as well as its potential to extend the survival substantially, even when progressive on tyrosine kinase inhibitors.