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There is no place for targeted therapy neoadjuvant treatment in Polish Health System - An analysis of radical nephrectomies in patients with large kidney tumors.

Kłącz J, Matuszewski M, Michajłowski J, Zachalski W, Markuszewski M, Krajka K - Cent European J Urol (2013)

Bottom Line: After a few months, five of patients (41.6%) required systemic therapy due to lymph node involvement.Patients with large kidney tumors should be treated in selected medical centers that have experience in the treatment of such cases.Radical nephrectomy has to be the method of choice in the treatment of patients with this kind of tumor and its diameter should not disqualify from surgical treatment, which is still the only chance for the patients to be cured, as no adjuvant chemotherapy treatment has proved to be significantly effective.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Gdańsk, Poland.

ABSTRACT

Introduction: Despite the introduction of better diagnostic tools, very large kidney tumors are still not so rare in our country. The paper presents our experience in the treatment of 12 patients with kidney tumors larger than 14 cm in size.

Material and methods: Between spring 2009 and autumn 2011, radical nephrectomies were performed in 12 patients due to a large kidney tumor (larger than 14 cm in size). Symptoms (hematuria, weight loss, anemia, etc.) were not present in all the patients, but the kidney tumor was confirmed by imaging studies (ultrasound, CT, MRI) in all of them.

Results: Full recovery was observed with no severe complications in all of the patients treated with radical nephrectomy. Pathological staging was correctly established by imaging studies in all of them. After a few months, five of patients (41.6%) required systemic therapy due to lymph node involvement.

Conclusions: Patients with large kidney tumors should be treated in selected medical centers that have experience in the treatment of such cases. Radical nephrectomy has to be the method of choice in the treatment of patients with this kind of tumor and its diameter should not disqualify from surgical treatment, which is still the only chance for the patients to be cured, as no adjuvant chemotherapy treatment has proved to be significantly effective.

No MeSH data available.


Related in: MedlinePlus

MRI scan – crossection through the tumor (longitudinal length of tumor – 16 cm).
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Figure 0002: MRI scan – crossection through the tumor (longitudinal length of tumor – 16 cm).

Mentions: Kidney tumors were diagnosed by ultrasound (gross hypo–echoic tumor mass blurring normal kidney shape) and confirmed by CT (11/12) or MR (1/12) imaging – gross kidney lesions with heterogenous contrast enhancement (Figs. 1A, 1B). In six of the 12 patients, the kidney mass extended into the renal vein. In one patient the kidney cancer thrombus grossly extended into vena cava inferior below the diaphragm. Imaging modalities (CT/MR) indicted periaortic lymph nodes suspicious for metastases in five patients (41.6%). In four patients (33%), the kidney tumor was the only finding. Clinical details are presented in Tab. 1.


There is no place for targeted therapy neoadjuvant treatment in Polish Health System - An analysis of radical nephrectomies in patients with large kidney tumors.

Kłącz J, Matuszewski M, Michajłowski J, Zachalski W, Markuszewski M, Krajka K - Cent European J Urol (2013)

MRI scan – crossection through the tumor (longitudinal length of tumor – 16 cm).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921841&req=5

Figure 0002: MRI scan – crossection through the tumor (longitudinal length of tumor – 16 cm).
Mentions: Kidney tumors were diagnosed by ultrasound (gross hypo–echoic tumor mass blurring normal kidney shape) and confirmed by CT (11/12) or MR (1/12) imaging – gross kidney lesions with heterogenous contrast enhancement (Figs. 1A, 1B). In six of the 12 patients, the kidney mass extended into the renal vein. In one patient the kidney cancer thrombus grossly extended into vena cava inferior below the diaphragm. Imaging modalities (CT/MR) indicted periaortic lymph nodes suspicious for metastases in five patients (41.6%). In four patients (33%), the kidney tumor was the only finding. Clinical details are presented in Tab. 1.

Bottom Line: After a few months, five of patients (41.6%) required systemic therapy due to lymph node involvement.Patients with large kidney tumors should be treated in selected medical centers that have experience in the treatment of such cases.Radical nephrectomy has to be the method of choice in the treatment of patients with this kind of tumor and its diameter should not disqualify from surgical treatment, which is still the only chance for the patients to be cured, as no adjuvant chemotherapy treatment has proved to be significantly effective.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Gdańsk, Poland.

ABSTRACT

Introduction: Despite the introduction of better diagnostic tools, very large kidney tumors are still not so rare in our country. The paper presents our experience in the treatment of 12 patients with kidney tumors larger than 14 cm in size.

Material and methods: Between spring 2009 and autumn 2011, radical nephrectomies were performed in 12 patients due to a large kidney tumor (larger than 14 cm in size). Symptoms (hematuria, weight loss, anemia, etc.) were not present in all the patients, but the kidney tumor was confirmed by imaging studies (ultrasound, CT, MRI) in all of them.

Results: Full recovery was observed with no severe complications in all of the patients treated with radical nephrectomy. Pathological staging was correctly established by imaging studies in all of them. After a few months, five of patients (41.6%) required systemic therapy due to lymph node involvement.

Conclusions: Patients with large kidney tumors should be treated in selected medical centers that have experience in the treatment of such cases. Radical nephrectomy has to be the method of choice in the treatment of patients with this kind of tumor and its diameter should not disqualify from surgical treatment, which is still the only chance for the patients to be cured, as no adjuvant chemotherapy treatment has proved to be significantly effective.

No MeSH data available.


Related in: MedlinePlus