Surgical Approach in Metastatic Renal Cell Carcinoma: A Literature Review

Matuszczak, Milena; Kiljańczyk, Adam; Salagierski, Maciej

doi:10.3390/cancers15061804

Cited by 7 publications

(4 citation statements)

References 60 publications

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“…The primary therapeutic goal is to achieve complete metastasectomy whenever it is surgically feasible. Undertaking any type of metastasectomy can enhance patient survival [39]. In our case, surgical intervention was absolutely indicated due to the development of an acute abdomen resulting from the perforation of an RCC metastasis.…”

Section: Surgical Management Of Rcc Metastasesmentioning

confidence: 86%

“…However, in scenarios where targeted therapies do not yield dramatic results, surgical excision of isolated metastases continues to be a vital component in the treatment strategy for metastatic RCC [38]. Complete resection of the metastatic lesions is considered the most effective treatment for RCC metastases, and surgery remains the treatment of choice for localized metastatic RCC [39].…”

Section: Surgical Management Of Rcc Metastasesmentioning

confidence: 99%

See 1 more Smart Citation

Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review

Todorovic,

Stojanovic,

Filip

et al. 2024

Diagnostics

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This case report presents a unique instance of small bowel perforation caused by solitary metastasis from renal cell carcinoma (RCC), a rare and complex clinical scenario. The patient, a 59-year-old male with a history of RCC treated with nephrectomy four years prior, presented with acute abdomen symptoms. Emergency diagnostic procedures identified a significant lesion in the small intestine. Surgical intervention revealed a perforated jejunal segment due to metastatic RCC. Postoperatively, the patient developed complications, including pneumonia and multi-organ failure, leading to death 10 days after surgery. Histopathological analysis confirmed the metastatic nature of the lesion. This case underscores the unpredictable nature of RCC metastasis and highlights the need for vigilance in post-nephrectomy patients. The rarity of small bowel involvement by RCC metastasis, particularly presenting as perforation, makes this case a significant contribution to medical literature, emphasizing the challenges in the diagnosis and management of such atypical presentations.

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Section: Surgical Management Of Rcc Metastasesmentioning

confidence: 86%

Section: Surgical Management Of Rcc Metastasesmentioning

confidence: 99%

Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review

Todorovic,

Stojanovic,

Filip

et al. 2024

Diagnostics

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“…They are often misdiagnosed as metastatic bone disease, especially in patients with a history of malignancy. Metastatic renal cell carcinoma (RCC) can have an aggressive course and can present with synchronous or metachronous metastasis in up to 20-30% of patients [ 1 ]. The 5-year overall survival of mRCC is about 20%.…”

Section: Introductionmentioning

confidence: 99%

Brown Tumor From Secondary Hyperparathyroidism Mimicking Metastatic Renal Cell Carcinoma in a Patient With End-Stage Renal Disease

Fogwe,

Ganipisetti,

Naha

2024

Cureus

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Brown tumors (also known as osteitis fibrosa cystica) are rare complications of end-stage renal disease (ESRD) and secondary hyperparathyroidism (HPT), characterized by focal bone lesions that resemble neoplasms. They are often misdiagnosed as metastatic bone disease, especially in patients with a history of malignancy. We present a case of a 60-year-old man with a history of renal cell carcinoma (RCC), and ESRD on hemodialysis (HD), who developed diffuse bone lesions on imaging with osteolytic/osteoblastic appearance concerning metastases, but on further workup was found to have brown tumors. We discuss the treatment and outcome and briefly review the relevant medical literature.

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“…In the setting of the surgical management of mRCC, a meta-analysis by Zaid et al reported that a complete MST was associated with a reduced risk of all-cause mortality compared to incomplete surgical MST (pooled aHR 2.37, 95% CI 2.03–2.87, p < 0.001), with low heterogeneity (I 2 = 0%) [ 10 ]. On the other hand, a literature review by Matuszczak et al [ 11 ] reported that every group of patients with mRCC with a limited metastatic burden can benefit from a MST surgical procedure as long as their global health status allows them to undergo this procedure. Therefore, the optimal therapy may be tailored individually; above all, for younger patients with good clinical condition and low comorbidities, a surgical approach should always be considered to achieve a more likely “non-evidence of disease” (NED) status.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Metastasectomy on Survival Outcomes of Renal Cell Carcinoma: A 10-Year Single Center Experience

Ferriero

Cacciatore

Ochoa

et al. 2023

Cancers

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Objectives: The role of surgical metastasectomy (MST) in solitary or oligometastasis from renal cell carcinoma (RCC) and its impact on survival outcomes remains poorly addressed. We evaluated the impact of MST on overall survival (OS) in patients with oligometastatic (m)RCC. Materials and methods: The institutional renal cancer prospective database was examined for cases treated with partial or radical nephrectomy who developed metastatic disease during follow-up. Patients with evidence of clinical metastasis at first diagnosis were excluded. Patients considered unfit for MST received systemic treatment (ST); all others received MST. The impact of MST vs. the ST only cohort was assessed with the Kaplan–Meier method. Age, gender, bilaterality, histology, AJCC stage of primary tumor, surgical margins, local vs. distant metastasis and MST were included in univariable and multivariable regression analyses to assess the predictors of OS. Results: Overall, at a median follow-up of 16 months after primary treatment, 168 patients with RCC developed asynchronous metastasis at the adrenal gland, lung, liver, spleen, peritoneal, renal fossa, bone, nodes, brain and thyroid gland. Nine patients unfit for any treatment were excluded. The site of metastasis was treated with surgical MST (77/159, 48.4%), with or without previous or subsequent ST, while 82/159 cases (51.2%) received ST only. The 2-year, 5-year and 10-year OS probabilities were 93.8%, 82.8% and 79.5%, respectively. After multivariable analysis, MST and the primary tumor AJCC stage were independent predictors of OS probabilities (p = 0.019 and p = 0.035, respectively). After Kaplan–Meier analysis, MST significantly improved OS probabilities versus patients receiving ST (p < 0.001). Limitations: The main drawbacks of our research were the small sample size from a single-tertiary referral institution, as well as the absent or different ST lines in the cohort of patients receiving MST. Conclusions: When an NED status is achievable, surgical MST of mRCC significantly impacts OS, delaying and not precluding further subsequent ST.

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Surgical Approach in Metastatic Renal Cell Carcinoma: A Literature Review

Cited by 7 publications

References 60 publications

Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review

Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review

Brown Tumor From Secondary Hyperparathyroidism Mimicking Metastatic Renal Cell Carcinoma in a Patient With End-Stage Renal Disease

The Impact of Metastasectomy on Survival Outcomes of Renal Cell Carcinoma: A 10-Year Single Center Experience

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