[Partial nephrectomy after neoadjuvant administration of sunitinib facilitates preservation of a solitary kidney].
We report on a 66-year-old female patient, presenting with a renal mass of 7.1 cm diameter on CT scan indicative of malignancy in the left solitary kidney. At first, the attempt at an open partial nephrectomy was undertaken. The intraoperative findings, however, did not allow for a kidney-preserving surgical procedure, mostly due to the close proximity of the tumour to the hilar vessels. The histopathology obtained during the procedure showed a clear cell renal cell carcinoma. Thus, systemic therapy with sunitinib over a period of 70 days (2 cycles/50 mg p. d.) was initiated. The subsequent CT scan showed shrinkage of the tumour with a partial response according to RECIST criteria (response evaluation criteria in solid tumours) of 32%. After discontinuation of sunitinib therapy, a partial nephrectomy was possible without complications. Postoperative follow-up was uneventful. The glomerular filtration rate before discharge was stable at 48 mL/min. The final tumour pathology showed a clear cell renal cell carcinoma - pTNM: pT1b, pNx, G2, R0.
Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover. Klot.christoph@mh-hannover.de
C
C
von Klot
J U
JU
Becker
V
V
Grünwald
I
I
Peters
M A
MA
Kuczyk
A S
AS
Merseburger
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007211:Indoles / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D059351:Organ Sparing Treatments / Q000379:methods*; D011758:Pyrroles / Q000008:administration & dosage*; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib