title: Carcinoma of the collecting ducts of Bellini of the kidney: adjuvant chemotherapy followed by multikinase inhibition with sunitinib.
abstract: BACKGROUND
  Carcinoma of the collecting ducts (CDC) of Bellini of the kidney is very rare but is among the most aggressive urologic entities.
  
  
  METHODS
  Radical nephrectomy revealed CDC in stage pT3a pN2 M0 G3 in 2 male patients. Four courses of adjuvant chemotherapy with cisplatin and gemcitabine were given.
  
  
  RESULTS
  Subsequent restaging revealed local recurrence and lymph node metastases. Both patients were operated on again, and metastatic CDC was found. Second-line therapy with sunitinib was administered. After 2 cycles, multiple liver, lung, and bone metastases and mediastinal lymphopathy occurred. Eight weeks later, the patients died, with a survival of 8 months from initial diagnosis.
  
  
  CONCLUSIONS
  Nephrectomy, adjuvant gemcitabine/cisplatin, and sunitinib therapy did not alter the course of disease in these patients. Gross resection of disease was rapidly followed by local recurrence and, subsequently, widespread dissemination of disease. Clinical trial investigation is urgently needed because of the aggressive and refractory nature of CDC.
authors.affiliation: Department of Urology, University of Munich, Klinikum Grosshadern, Germany. michael.staehler@med.uni-muenchen.de
authors.forename: Michael
authors.initials: M
authors.lastname: Staehler
authors.forename: Gita
authors.initials: G
authors.lastname: Schöppler
authors.forename: Nico
authors.initials: N
authors.lastname: Haseke
authors.forename: Thomas
authors.initials: T
authors.lastname: Stadler
authors.forename: Alexander
authors.initials: A
authors.lastname: Karl
authors.forename: Michael
authors.initials: M
authors.lastname: Siebels
authors.forename: Stephan
authors.initials: S
authors.lastname: Ihrler
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D007685:Kidney Tubules, Collecting / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage; D000077210:Sunitinib; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D007211:Indoles; D011758:Pyrroles; D003841:Deoxycytidine; D002945:Cisplatin; D000077210:Sunitinib; D000093542:Gemcitabine