Preview

Злокачественные опухоли

Расширенный поиск

Мультимодальное лечение двусторонних опухолей почек как способ улучшения онкологических и функциональных результатов: клинический случай и обзор литературы

https://doi.org/10.18027/2224-5057-2011-1-21-28

Полный текст:

Аннотация

Почечно-клеточный рак (ПКР) может поражать как одну, так и обе почки. Описаны случаи мультифокального поражения одной почки. Синхронные и метахронные двусторонние опухоли почек представляют серьезную медицинскую проблему, которая должна быть решена наилучшим путем с точки зрения радикальности лечения и максимального сохранения функции почек. 

Мы представляем описание клинического случая метахронного ПКР с рецидивом в ипсилатеральной и контралатеральной почке. У этого пациента было использовано несколько методик, направленных на сохранение функции нефронов. Был проведен обзор литературы по заболеваемости, лечению и исходам синхронного и метахронного ПКР, а также по вариантам лечения, доступным таким больным. 

Мы использовали сочетание открытых и малоинвазивных методик, направленных на сохранение функции почек, включая открытую резекцию почки и лапароскопическую криотерапию. По прошествии 5 лет наблюдения пациент не имеет признаков болезни и ему не требуется проведение гемодиализа. Двусторонние опухоли почек встречаются нередко и могут представлять значительную проблему при выборе методов лечения с учетом необходимости сохранения функции почек. Результаты лечения можно улучшить при использовании мультимодального подхода, включающего малоинвазивные и открытые процедуры. 

Об авторах

JENNIFER YATES
Department of Urology, Hackensack University Medical Center, 360 Essex Street, Suite 403, Hackensack, NJ 07601, United States. Tel. +1 201 336-8090
Соединённые Штаты Америки


RAVI MUNVER
Hackensack University Medical Center, Hackensack, NJ; Touro University College of Medicine, NY; University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, United States
Соединённые Штаты Америки


DAVID CRAWLEY
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, United States
Соединённые Штаты Америки


THOMAS CHRISTIANO
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, United States
Соединённые Штаты Америки


IHOR SAWCZUK
Hackensack University Medical Center, Hackensack, NJ; Touro University College of Medicine, NY; University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, United States
Соединённые Штаты Америки


Список литературы

1. Jemal, A., Siegal, R., Ward E.: Cancer Statistics. A Cancer Journal for Clinicians, caac.20006v2, 5-27-2009

2. Chow, W. H., Devesa, S. S., Warren, J. L., Fraumeni, J. F., Jr.: Rising incidence of renal cell cancer in the United States. JAMA, 281: 1628, 1999

3. Hollingsworth, J. M., Miller, D. C., Daignault, S., Hollenbeck, B. K.: Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst, 98: 1331, 2006

4. Lopez-Beltran, A., Carrasco, J. C., Cheng, L., Scarpelli, M., Kirkali, Z., Montironi, R.: 2009 update on the classification of renal epithelial tumors in adults. Int J Urol, 16: 432, 2009

5. Linehan, W. M.: Genetic basis of bilateral renal cancer: implications for evaluation and management. J Clin Oncol, 27: 3731, 2009

6. Boris, R., Proano, M., Linehan, W. M., Pinto, P. A., Bratslavsky, G.: Initial experience with robot assisted partial nephrectomy for multiple renal masses. J Urol, 182: 1280, 2009

7. Linehan, W. M., Vasselli, J., Srinivasan, R., Walther, M. M., Merino, M., Choyke, P. et al.: Genetic basis of cancer of the kidney: disease-specific approaches to therapy. Clin Cancer Res, 10: 6282S, 2004

8. Rosner, B., Polk, B. F.: The implications of blood pressure variability for clinical and screening purposes. J Chronic Dis, 32: 451, 1979

9. Feldman, D. R., Motzer, R. J.: Novel targets and therapies for metastatic renal cell carcinoma. Oncology (Williston Park), 20: 1745, 2006

10. Kruck, S., Merseburger, A. S., Gakis, G., Kramer, M. W., Stenzl, A., Kuczyk, M. A.: An update on the medical therapy of advanced metastatic renal cell carcinoma. Scand J Urol Nephrol, 42: 501, 2008

11. Rini, B. I., Bukowski, R. M.: Targeted therapy for metastatic renal cell carcinoma: a home run or a work in progress? Oncology (Williston Park), 22: 388, 2008

12. Go, A. S., Chertow, G. M., Fan, D., McCulloch, C. E., Hsu, C. Y.: Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med, 351: 1296, 2004

13. Huang, W. C., Levey, A. S., Serio, A. M., Snyder, M., Vickers, A. J., Raj, G. V. et al.: Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol, 7: 735, 2006

14. Huang, W. C., Elkin, E. B., Levey, A. S., Jang, T. L., Russo, P.: Partial nephrectomy versus radical nephrectomy in patients with small renal tumors--is there a difference in mortality and cardiovascular outcomes? J Urol, 181: 55, 2009

15. Thompson, R. H., Boorjian, S. A., Lohse, C. M., Leibovich, B. C., Kwon, E. D., Cheville, J. C. et al.: Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol, 179: 468, 2008

16. Weiner, D. E., Tabatabai, S., Tighiouart, H., Elsayed, E., Bansal, N., Griffith, J. et al.: Cardiovascular outcomes and all-cause mortality: exploring the interaction between CKD and cardiovascular disease. Am J Kidney Dis, 48: 392, 2006

17. Koenig, P., Gill, I.S., Kamoi K., Aron, M., Haber, G., Singh, A.B., Weight, CJ, Desai, MM, Kaouk, JH, Goldfarb, DA, Poggio, E.D.: Kidney cancer and the risk for chronic kidney disease: matched-paired comparison with living donors. The Journal of Urology, 179: 170, April 2008

18. McKiernan, J., Simmons, R., Katz, J., Russo, P.: Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology, 59: 816, 2002

19. System, U. S. R. D.: Annual Data Report. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), and US Department of Health and Human Services (DHHS). 2007

20. Foley, R. N., Parfrey, P. S., Sarnak, M. J.: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis, 32: S112, 1998

21. Rocco, M., Frankenfield, DL, Hopson SK, McClellan WM: Relationship between clinical performance measures and outcomes among patients receiving long-term hemodialysis. Ann. Intern. Med, 145: 512, 2006

22. Neil, N., Guest, S., Wong, L., Inglese, G., Bhattacharyya, S. K., Gehr, T. et al.: The financial implications for Medicare of greater use of peritoneal dialysis. Clin Ther, 31: 880, 2009

23. Kasiske, B. L., Cangro, C. B., Hariharan, S., Hricik, D. E., Kerman, R. H., Roth, D. et al.: The evaluation of renal transplantation candidates: clinical practice guidelines. Am J Transplant, 1 Suppl 2: 3, 2001

24. Lin, S. J., et al.: The association between length of post-kidney transplant hospitalization and long-term graft and recipient survival. Clin. Transplant, 20: 245, 2006

25. Campbell, S. C., Novick, A. C., Belldegrun, A., Blute, M. L., Chow, G. K., Derweesh, I. H. et al.: Guideline for management of the clinical T1 renal mass. J Urol, 182: 1271, 2009

26. Leibovich, B. C., Blute, M. L., Cheville, J. C., Lohse, C. M., Weaver, A. L., Zincke, H.: Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol, 171: 1066, 2004

27. Touijer, K., Jacqmin, D., Kavoussi, L. R., Montorsi, F., Patard, J. J., Rogers, C. G. et al.: The expanding role of partial nephrectomy: a critical analysis of indications, results, and complications. Eur Urol, 57: 214, 2010

28. Gupta, G. N., Peterson, J., Thakore, K. N., Pinto, P. A., Linehan, W. M., Bratslavsky, G.: Oncological Outcomes of Partial Nephrectomy for Multifocal Renal Cell Carcinoma Greater Than 4 cm. J Urol, 2010

29. Dash, A., Vickers, A. J., Schachter, L. R., Bach, A. M., Snyder, M. E., Russo, P.: Comparison of outcomes in elective partial vs radical nephrectomy for clear cell renal cell carcinoma of 4-7 cm. BJU Int, 97: 939, 2006

30. Breau, R. H., Crispen, P. L., Jimenez, R. E., Lohse, C. M., Blute, M. L., Leibovich, B. C.: Outcome of stage T2 or greater renal cell cancer treated with partial nephrectomy. J Urol, 183: 903, 2010

31. Woldu, S. L., Barlow, L. J., Patel, T., Hruby, G. W., Benson, M. C., McKiernan, J. M.: Single Institutional Experience with Nephron-sparing Surgery for Pathologic Stage T3bNxM0 Renal Cell Carcinoma Confined to the Renal Vein. Urology, 2010

32. Kolla, S. B., Ercole, C., Spiess, P. E., Pow-Sang, J. M., Sexton, W. J.: Nephron-sparing surgery for pathological stage T3b renal cell carcinoma confined to the renal vein. BJU Int, 2010

33. Kaul, S., Laungani, R., Sarle, R., Stricker, H., Peabody, J., Littleton, R. et al.: da Vinci-assisted robotic partial nephrectomy: technique and results at a mean of 15 months of follow-up. Eur Urol, 51: 186, 2007

34. Ho, H., Schwentner, C., Neururer, R., Steiner, H., Bartsch, G., Peschel, R.: Robotic-assisted laparoscopic partial nephrectomy: surgical technique and clinical outcomes at 1 year. BJU Int, 103: 663, 2009

35. Gettman, M. T., Blute, M. L., Chow, G. K., Neururer, R., Bartsch, G., Peschel, R.: Robotic-assisted laparoscopic partial nephrectomy: technique and initial clinical experience with DaVinci robotic system. Urology, 64: 914, 2004

36. Caruso, R. P., Phillips, C. K., Kau, E., Taneja, S. S., Stifelman, M. D.: Robot assisted laparoscopic partial nephrectomy: initial experience. J Urol, 176: 36, 2006

37. Phillips, C. K., Taneja, S. S., Stifelman, M. D.: Robotassisted laparoscopic partial nephrectomy: the NYU technique. J Endourol, 19: 441, 2005

38. Michli, E. E., Parra, R. O.: Robotic-assisted laparoscopic partial nephrectomy: initial clinical experience. Urology, 73: 302, 2009

39. Deane, L. A., Lee, H. J., Box, G. N., Melamud, O., Yee, D. S., Abraham, J. B. et al.: Robotic versus standard laparoscopic partial/wedge nephrectomy: a comparison of intraoperative and perioperative results from a single institution. J Endourol, 22: 947, 2008

40. Rogers, C. G., Metwalli, A., Blatt, A. M., Bratslavsky, G., Menon, M., Linehan, W. M. et al.: Robotic partial nephrectomy for renal hilar tumors: a multi-institutional analysis. J Urol, 180: 2353, 2008

41. Rogers, C. G., Singh, A., Blatt, A. M., Linehan, W. M., Pinto, P. A.: Robotic partial nephrectomy for complex renal tumors: surgical technique. Eur Urol, 53: 514, 2008

42. Gill, I. S., Kavoussi, L. R., Lane, B. R., Blute, M. L., Babineau, D., Colombo, J. R., Jr. et al.: Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol, 178: 41, 2007

43. Aron, M., Koenig, P., Kaouk, J. H., Nguyen, M. M., Desai, M. M., Gill, I. S.: Robotic and laparoscopic partial nephrectomy: a matched-pair comparison from a highvolume centre. BJU Int, 102: 86, 2008

44. Wang, A. J., Bhayani, S. B.: Robotic partial nephrectomy versus laparoscopic partial nephrectomy for renal cell carcinoma: single-surgeon analysis of >100 consecutive procedures. Urology, 73: 306, 2009

45. Kutikov, A., Uzzo, R. G.: The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol, 182: 844, 2009

46. Boris, R. S., Sanford, T., Pinto, P.A, Linehan M.L., Bratslavsky G.: Off-clamp robot assisted partial nephrectomy for multifocal renal masses in the hereditary renal population. Journal of Urology, 183: e370, April 2010

47. Chung, P. H., Gupta G., Boris R.S.,Linehan W.M., Pinto P.A., Bratslavsky G.: Robot assisted laparoscopic partial nephrectomy for tumors greater than 4cm: Feasibility and early functional outcomes. Journal of Urology, 183: e355, April 2010

48. White, W. M., Haber, G. P., Goel, R. K., Crouzet, S., Stein, R. J., Kaouk, J. H.: Single-port urological surgery: single-center experience with the first 100 cases. Urology, 74: 801, 2009

49. Haber, G. P., Crouzet, S., Kamoi, K., Berger, A., Aron, M., Goel, R. et al.: Robotic NOTES (Natural Orifice Translumenal Endoscopic Surgery) in reconstructive urology: initial laboratory experience. Urology, 71: 996, 2008

50. Lee, B. R., Wolf, J. S., Jr.: Natural orifice transluminal endoscopic surgery (NOTES) partial nephrectomy. B. R. Lee, U. Boylu, M. Oommen, G. Fifer, R. Thomas and V. Joshi. J Urol, 183: 1731, 2010

51. Carraway, W. A., Raman, J. D., Cadeddu, J. A.: Current status of renal radiofrequency ablation. Curr Opin Urol, 19: 143, 2009

52. Pasticier, G., Timsit, M. O., Badet, L., De La Torre Abril, L., Halila, M., Fassi Fehri, H. et al.: Nephron-sparing surgery for renal cell carcinoma: detailed analysis of complications over a 15-year period. Eur Urol, 49: 485, 2006

53. Committee., A. P. G.: Chapter 1: Management of the clinical stage 1 renal mass: diagnosis and treatment recommendations. AUA guideline for management of the clinical stage 1 renal mass: 1, 2009

54. Zagoria, R. J., Hawkins, A. D., Clark, P. E., Hall, M. C., Matlaga, B. R., Dyer, R. B. et al.: Percutaneous CT-guided radiofrequency ablation of renal neoplasms: factors influencing success. AJR Am J Roentgenol, 183: 201, 2004

55. Raman, J. D., Raj, G. V., Lucas, S. M., Williams, S. K., Lauer, E. M., Ahrar, K. et al.: Renal functional outcomes for tumours in a solitary kidney managed by ablative or extirpative techniques. BJU Int, 105: 496, 2010

56. Park, S., Anderson, J. K., Matsumoto, E. D., Lotan, Y., Josephs, S., Cadeddu, J. A.: Radiofrequency ablation of renal tumors: intermediate-term results. J Endourol, 20: 569, 2006

57. McDougal, W. S., Gervais, D. A., McGovern, F. J., Mueller, P. R.: Long-term followup of patients with renal cell carcinoma treated with radio frequency ablation with curative intent. J Urol, 174: 61, 2005

58. Levinson, A. W., Su, L. M., Agarwal, D., Sroka, M., Jarrett, T. W., Kavoussi, L. R. et al.: Long-term oncological and overall outcomes of percutaneous radio frequency ablation in high risk surgical patients with a solitary small renal mass. J Urol, 180: 499, 2008

59. Gervais, D. A., McGovern, F. J., Arellano, R. S., McDougal, W. S., Mueller, P. R.: Renal cell carcinoma: clinical experience and technical success with radio-frequency ablation of 42 tumors. Radiology, 226: 417, 2003

60. Malcolm, J. B., Berry, T. T., Williams, M. B., Logan, J. E., Given, R. W., Lance, R. S. et al.: Single center experience with percutaneous and laparoscopic cryoablation of small renal masses. J Endourol, 23: 907, 2009

61. Weld, K. J., Figenshau, R. S., Venkatesh, R., Bhayani, S. B., Ames, C. D., Clayman, R. V. et al.: Laparoscopic cryoablation for small renal masses: three-year follow-up. Urology, 69: 448, 2007

62. Lawatsch, E. J., Langenstroer, P., Byrd, G. F., See, W. A., Quiroz, F. A., Begun, F. P.: Intermediate results of laparoscopic cryoablation in 59 patients at the Medical College of Wisconsin. J Urol, 175: 1225, 2006

63. Gill, I. S., Remer, E. M., Hasan, W. A., Strzempkowski, B., Spaliviero, M., Steinberg, A. P. et al.: Renal cryoablation: outcome at 3 years. J Urol, 173: 1903, 2005

64. Aron, M., Kamoi, K., Remer, E., Berger, A., Desai, M., Gill, I.: Laparoscopic renal cryoablation: 8-year, single surgeon outcomes. J Urol, 183: 889, 2010

65. Stone, M. J., Venkatesan, A. M., Locklin, J., Pinto, P., Linehan, M., Wood, B. J.: Radiofrequency ablation of renal tumors. Tech Vasc Interv Radiol, 10: 132, 2007

66. Grimaldi, G., Reuter, V., Russo, P.: Bilateral non-familial renal cell carcinoma. Ann Surg Oncol, 5: 548, 1998

67. Klatte, T., Wunderlich, H., Patard, J. J., Kleid, M. D., Lam, J. S., Junker, K. et al.: Clinicopathological features and prognosis of synchronous bilateral renal cell carcinoma: an international multicentre experience. BJU Int, 100: 21, 2007

68. Siemer, S., Uder, M., Zell, A., Ponicke, C., Humke, U., Ziegler, M. et al.: [Bilateral kidney tumor. Therapy management and histopathological results with long-term follow-up of 66 patients]. Urologe A, 40: 114, 2001

69. Zincke, H., Swanson, S. K.: Bilateral renal cell carcinoma: influence of synchronous and asynchronous occurrence on patient survival. J Urol, 128: 913, 1982

70. Blute, M. L., Itano, N. B., Cheville, J. C., Weaver, A. L., Lohse, C. M., Zincke, H.: The effect of bilaterality, pathological features and surgical outcome in nonhereditary renal cell carcinoma. J Urol, 169: 1276, 2003

71. Boorjian, S. A., Uzzo, R. G.: The evolving management of small renal masses. Curr Oncol Rep, 11: 211, 2009 Bratslavsky G, Boris RS.

72. Wunderlich, H. e. a.: Multifocality in renal cell carcinoma: A bilateral event? Urol. Int., 63: 160, 1999

73. Kowalczyk, K. J., Hooper, H. B., Linehan, W. M., Pinto, P. A., Wood, B. J., Bratslavsky, G.: Partial nephrectomy after previous radio frequency ablation: the National Cancer Institute experience. J Urol, 182: 2158, 2009

74. Hwang, J. J., Walther, M. M., Pautler, S. E., Coleman, J. A., Hvizda, J., Peterson, J. et al.: Radio frequency ablation of small renal tumors:: intermediate results. J Urol, 171: 1814, 2004

75. Walther, M. C., Shawker, T. H., Libutti, S. K., Lubensky, I., Choyke, P. L., Venzon, D. et al.: A phase 2 study of radio frequency interstitial tissue ablation of localized renal tumors. J Urol, 163: 1424, 2000

76. Johnson, A., Sudarshan, S., Liu, J., Linehan, W. M., Pinto, P. A., Bratslavsky, G.: Feasibility and outcomes of repeat partial nephrectomy. J Urol, 180: 89, 2008

77. Ghavamian, R., Cheville, J. C., Lohse, C. M., Weaver, A. L., Zincke, H., Blute, M. L.: Renal cell carcinoma in the solitary kidney: an analysis of complications and outcome after nephron sparing surgery. J Urol, 168: 454, 2002

78. Saranchuk, J. W., Touijer, A. K., Hakimian, P., Snyder, M. E., Russo, P.: Partial nephrectomy for patients with a solitary kidney: the Memorial Sloan-Kettering experience. BJU Int, 94: 1323, 2004

79. Thompson, R. H., Leibovich, B. C., Lohse, C. M., Zincke, H., Blute, M. L.: Complications of contemporary open nephron sparing surgery: a single institution experience. J Urol, 174: 855, 2005

80. Magera, J. S., Jr., Frank, I., Lohse, C. M., Leibovich, B. C., Cheville, J. C., Blute, M. L.: Analysis of repeat nephron sparing surgery as a treatment option in patients with a solid mass in a renal remnant. J Urol, 179: 853, 2008

81. Stephenson, A. J., Hakimi, A. A., Snyder, M. E., Russo, P.: Complications of radical and partial nephrectomy in a large contemporary cohort. J Urol, 171: 130, 2004

82. Herring, J. C., Enquist, E. G., Chernoff, A., Linehan, W. M., Choyke, P. L., Walther, M. M.: Parenchymal sparing surgery in patients with hereditary renal cell carcinoma: 10-year experience. J Urol, 165: 777, 2001

83. Bratslavsky, G., Liu, J. J., Johnson, A. D., Sudarshan, S., Choyke, P. L., Linehan, W. M. et al.: Salvage partial nephrectomy for hereditary renal cancer: feasibility and outcomes. J Urol, 179: 67, 2008

84. Nguyen, C. T., Lane, B. R., Kaouk, J. H., Hegarty, N., Gill, I. S., Novick, A. C. et al.: Surgical salvage of renal cell carcinoma recurrence after thermal ablative therapy. J Urol, 180: 104, 2008

85. Rogers, C. G., Menon, M, Weise, E., Gettman, M., Frank, I.,Shepard, D., et al.: Robotic partial nephrectomy: a multi-institutional analysis. Journal of Robotic Surgery, 2: 141, 2008

86. Benway, B. M., Wang, A. J., Cabello, J. M., Bhayani, S. B.: Robotic partial nephrectomy with sliding-clip renorrhaphy: technique and outcomes. Eur Urol, 55: 592, 2009

87. Liu, N. W., Khurana, K., Sudarshan, S., Pinto, P. A., Linehan, W. M., Bratslavsky, G.: Repeat partial nephrectomy on the solitary kidney: surgical, functional and oncological outcomes. J Urol, 183: 1719, 2010


Для цитирования:


YATES J., MUNVER R., CRAWLEY D., CHRISTIANO T., SAWCZUK I. Мультимодальное лечение двусторонних опухолей почек как способ улучшения онкологических и функциональных результатов: клинический случай и обзор литературы. Злокачественные опухоли. 2011;1(1):21-28. https://doi.org/10.18027/2224-5057-2011-1-21-28

For citation:


., ., ., ., . . Malignant tumours. 2011;1(1):21-28. (In Russ.) https://doi.org/10.18027/2224-5057-2011-1-21-28

Просмотров: 131


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 2224-5057 (Print)
ISSN 2587-6813 (Online)