Management of Renal Collecting Duct Carcinoma: A Systematic Review and the McMaster Experience

Abstract

Introduction: Collecting duct carcinoma (CDC) is a rare, aggressive form of renal carcinoma that presents at an advanced stage and has a poor prognosis. Little is known concerning the optimal management of CDC. We present the results of a systematic review addressing the management of CDC and the McMaster University CDC series. Methods: The MEDLINE, Cochrane Library, and EMBASE databases and conference proceedings were searched to identify studies relating to the management of CDC. Included studies reported on a minimum of 10 subjects receiving a single intervention. Series in which an evaluation of therapeutic effectiveness was not possible were excluded. The McMaster University (Hamilton, Ontario) series of 6 cases of CDC were retrospectively reviewed. Results: We identified 3 studies relevant to the management of CDC that included a total of 72 patients. A gemcitabine–cisplatin or –carboplatin regimen resulted in a 26% objective response rate in 23 patients with metastatic CDC. Two additional studies indicated that 49 patients treated with immunotherapy achieved no response. In the McMaster series, cytoreductive nephrectomy was performed in 4 of 6 patients. In 2 patients, MVAC therapy (methotrexate–vinblastine–doxorubicin–cisplatin) achieved no response. No significant therapeutic complications occurred, but survival was poor (median: 11 months; range: 10–33 months). Conclusions: Our review and clinical experience suggest that the current standard of care for metastatic CDC is a gemcitabine–cisplatin regimen.

Collecting (Bellini) duct carcinoma: A clinical study of a rare tumour and review of the literature

“…17 Barrascout and colleagues presented a case report of complete remission of pulmonary metastases and long-term survival in patients treated with cisplatin, gemcitabine, and bevacizumab. 18 Six of our patients received chemotherapy GC, but all of them, except 1, progressed during or just after treatment. One patient had partial regression, with 5 months of remission.…”

Collecting duct of Bellini renal carcinoma with psoas muscle recurrence: A case report and review of literature

“…2 Presently only 270 cases have been reported worldwide. 2 It is more common in males and in the younger population (58-61 years). Like our patient, most cases present with gross hematuria, a renal mass or flank pain.…”

“…Most cases are detected at pT2-pT3 with perinephric extension. 1,2 In most countries, CDC appears to be unreported since its differentiation requires extensive histopathologic and immunohistochemical examinations.…”

“…3 Of all renal neoplasms, CDC has the worst prognosis with most patients eventually developing metastatic disease. 1,2 Our case initially presented as localized disease, which was completely excised by partial nephrectomy; however, it had metastasized. In our case, the metastasis was first noted in the psoas muscle without prior invasion to the regional lymph nodes.…”

Bellini Duct Carcinoma: Case Report and Review of the Literature

“…(6) metastatik BKK olgularında %26 objektif yanıt oranı elde ederek GS rejiminin etkinliğini göstermişlerdir. Başka yararlı ajan eksikliği göz önüne alındığında, GS rejimi metastatik BKK olgularında standart olarak sistemik tedavinin birinci basamağında düşünülmelidir (15 …”