title: Sorafenib neoadjuvant therapy in the treatment of high risk renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of sorafenib as preoperative neoadjuvant therapy in patients with high risk renal cell carcinoma (RCC).
  
  
  METHODS
  Clinical data of 18 patients with high risk RCC who received surgery done successfully after preoperative neoadjuvant therapy with sorafenib in Peking Union Medical College Hospital (PUMCH) from April 2007 to October 2013 have been reviewed and analyzed in this study.
  
  
  RESULTS
  Among the 18 patients there were 13 male and 5 female, with a median age of 54.6 years. The objective response rate (ORR) of the operation on the selected patients is very high (94.4%), including 4 cases (22.2%) of partial response (PR) and 13 cases (72.2%) of stable disease (SD). After preoperative sorafenib treatment, the average tumor size of the 18 patients decreased from 7.8 cm (ranging from 3.6 to 19.2 cm) to 6.2 cm (ranging from 2.4 to 16.8 cm), and the median value of average tumor CT value decreased from 61HU to 52 HU. Among the 5 patients who had IVC tumor thrombi, the grades of tumor thrombi in 2 patients who were grade II before sorafenib treatment became grade I and grade 0 respectively, 2 patients of grade III both became grade II.
  
  
  CONCLUSIONS
  Preoperative neoadjuvant therapy with sorafenib for high risk RCC patients can significantly decrease primary tumor volume as well as tumor thrombus, which could help the nephron-sparing surgery (NSS) or radical nephrectomy to be done successfully.
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Yushi
authors: Y
authors: Zhang
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Yongqiang
authors: Y
authors: Li
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Jianhua
authors: J
authors: Deng
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Zhigang
authors: Z
authors: Ji
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Hongyan
authors: H
authors: Yu
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Hanzhong
authors: H
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D057234:Preoperative Period; D012306:Risk; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
references: Ann Oncol. 2012 Oct;23 Suppl 7:vii65-71
references: 22997456
references: Cancer. 2013 Jan 15;119(2):388-94
references: 23147245
references: J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
references: 10655437
references: Lancet. 2009 Mar 28;373(9669):1119-32
references: 19269025
references: N Engl J Med. 2007 Jan 11;356(2):125-34
references: 17215530
references: Urol Oncol. 2013 Oct;31(7):1316-20
references: 22264501
references: J Urol. 2014 Jun;191(6):1665-70
references: 24423441
references: Eur Radiol. 2012 Jul;22(7):1430-41
references: 22367468
references: Urol Int. 2008;80(4):451-3
references: 18587261
references: Expert Opin Pharmacother. 2012 Feb;13(3):407-19
references: 22263843
references: BMC Cancer. 2009;9:249
references: 19622166
references: World J Urol. 2010 Jun;28(3):247-52
references: 20390283
references: Curr Clin Pharmacol. 2011 Aug;6(3):144-50
references: 21827393
references: Oncol Lett. 2012 Apr 1;3(4):935-939
references: 22741022
references: Ther Adv Urol. 2013 Dec;5(6):338-53
references: 24294292
references: Int J Urol. 2007 Dec;14(12):1095-7; discussion 1097
references: 18036049
references: Anticancer Drugs. 2009 Jul;20(6):409-15
references: 19436197
references: Onco Targets Ther. 2014 Jun 06;7:925-35
references: 24944516
references: Int J Urol. 2012 Oct;19(10):903-7
references: 22640774
references: Cancer. 1995 Sep 1;76(5):824-32
references: 8625186