Advanced-stage renal cell carcinoma treated by radical nephrectomy and adjacent organ or structure resection Journal Article
| Authors: | Karellas, M. E.; Jang, T. L.; Kagiwada, M. A.; Kinnaman, M. D.; Jarnagin, W. R.; Russo, P. |
| Article Title: | Advanced-stage renal cell carcinoma treated by radical nephrectomy and adjacent organ or structure resection |
| Abstract: | OBJECTIVE: To examine the effect of radical nephrectomy (RN) with adjacent organ and structure resection on survival, as invasion of adjacent organs in patients with renal cell carcinoma (RCC) is rare. PATIENTS AND METHODS: After institutional review board approval, we reviewed our database and statistically analysed of patients with pathological stage T3 or T4 RCC who had RN and resection of a contiguous organ or structure. RESULTS: We identified 38 patients of 2464 (1.5%) who had RN with adjacent organ or structure resection. The median (interquartile range) size of the mass was 11 (8-14) cm, and the follow-up 13 (5-33) months. Most patients (68%) were pT4 stage and had conventional clear cell carcinoma (95%). Fourteen patients (37%) had positive surgical margins. The liver (10) was the most commonly resected adjacent organ or structure. Only one patient remains alive with no evidence of disease at 5 years, while three are currently alive with disease. Overall, 34 of 38 patients (90%) ultimately died from disease at a median (range) of 11.7 (5.4-29.2) months after surgical resection. The surgical margin status was the only statistically significant factor for recurrence and death (P = 0.006). CONCLUSIONS: The prognosis for patients with advanced RCC and adjacent organ or structure involvement is extremely poor and similar to that of patients with metastatic disease. These patients should be thoroughly counselled about the impact of surgical management and considered for entry into neoadjuvant or adjuvant clinical trials with new targeted systemic agents. © 2008 The Authors. |
| Keywords: | adult; cancer survival; clinical article; treatment outcome; aged; middle aged; survival analysis; retrospective studies; sorafenib; interferon; cancer staging; follow up; neoplasm staging; interleukin 2; tumor volume; tomography, x-ray computed; renal cell carcinoma; kidney carcinoma; kidney neoplasms; nephrectomy; cancer invasion; carcinoma, renal cell; adjuvant chemotherapy; neoplasm metastasis; clear cell carcinoma; retinoic acid; suramin; adjacent organ resection; advanced local renal cell cancer |
| Journal Title: | BJU International |
| Volume: | 103 |
| Issue: | 2 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2009-01-01 |
| Start Page: | 160 |
| End Page: | 164 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.2008.08025.x |
| PUBMED: | 18782305 |
| PROVIDER: | scopus |
| PMCID: | PMC2769168 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: BJINF" - "Source: Scopus" |
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