Skeletal Metastases in 102 Patients Evaluated Before Surgery for Renal Cell Carcinoma

Abstract

During a 3-year period a consecutive series of 102 patients were treated for renal cell carcinoma at one urological unit. Thirty-three patients (32.4%) had metastatic spread, but bone metastases were found in six patients only, i.e. 5.9% of the whole series and 18.2% of the patients with metastases preoperatively. The bone metastases had in all six patients given local symptoms first indicating radiography, and thereafter radionuclide scintigraphy of the entire skeleton. Bone scintigraphy performed merely by routine in 70 patients did not reveal one single case of bone metastasis. Only one patient had a solitary bone metastasis, and this metastasis was considered inoperable because of its location and size and the patient's age. The decision about nephrectomy was not in any case altered by the finding of bone metastases. Solitary bone metastasis must be diagnosed early since they may be radically removed. Routine scintigraphy of the skeleton in symptomless patients, however, has a low yield. Screening for skeletal metastases may therefore be best performed by careful physical examination and history-taking.

Is there a diagnostic role for bone scanning of patients with a high pretest probability for metastatic renal cell carcinoma?

“…Our findings are thus in agreement with Henriksson et al, 9 who found a low diagnostic value of SAP for the identification of patients with bone metastases and concluded that early diagnosis of a skeletal metastasis is best achieved by careful physical examination of the patient as well as careful history-taking. At many institutions, wholebody BS is still considered part of the staging assessment, at least for preselected patients.…”

Pulmonary metastasectomy in patients with renal cell carcinoma: a single-institution experience

“…Almost 30% of patients with RCC will progress to distant metastases during postoperative follow-up [1,2]. Thus, more than 50% of all patients with RCC develop metastases in the course of their disease and require individual treatment [3].…”

Metastasectomy in Renal Cell Carcinoma: A Multicenter Retrospective Analysis

“…In approximately 30% of patients with renal cell carcinoma (RCC), the primary diagnosis is made at a stage of metastasized cancer [1]. Moreover, of initially localized tumors, 30–50% progress to distant metastases [2, 3].…”