Deliberation on Deferred Cytoreductive Nephrectomy and Postoperative Treatment for Advanced Renal Cell Carcinoma: A Case Report

Overview

Journal Case Rep Oncol

Publisher Karger

Specialty Oncology

Date 2023 Jan 13

PMID 36636673

Authors

Takuya Nakagawa

Yoshihide Kawasaki

Satoko Sato

Hiromichi Katayama

Yohei Satake

Shuichi Shimada

Takuma Sato

Naoki Kawamorita

Shinichi Yamashita

Koji Mitsuzuka

Atsushi Kohyama

Masaharu Ishida

Hideo Ohtsuka

Michiaki Unno

Akihiro Ito

Affiliations

Soon will be listed here.

Abstract

In a rare case, free from systemic therapy, deferred cytoreductive nephrectomy was implemented in treating an advanced renal cell carcinoma with liver, lung, and splenic colon metastases. A 59-year-old man diagnosed with advanced renal cell carcinoma underwent deferred cytoreductive nephrectomy due to a partial response to systemic treatment after a period of 1 year. After the surgery, no additional treatment was implemented. Furthermore, after 10 months, the patient had no recurrence of renal cell carcinoma. Through a review of this case and deferred cases in the current literature, we could emphasize the importance of image evaluation and pathological findings as an indication for surgery and subsequent treatment options. However, there is room for debate with regards to the indications for deferred cytoreductive nephrectomy as well as a therapeutic strategy after the surgery. This report discusses the significance of deferred cytoreductive nephrectomy in terms of prognosis and quality-of-life improvement in advanced renal cancer.

Citing Articles

Report of case series: Correlation between pathological and radiological evaluation and clinical course of three cases of metastatic renal cell carcinoma with cytoreductive nephrectomy after combined immuno-oncology therapy.

Atagi Y, Tada K, Kouno R, Minato R, Hashine K IJU Case Rep. 2024; 7(4):341-345.

PMID: 38966777 PMC: 11221940. DOI: 10.1002/iju5.12752.

Impact of Cytoreductive Nephrectomy in the Management of Metastatic Renal Cell Carcinoma: A Multicenter Retrospective Study.

Kumada N, Iinuma K, Kubota Y, Takagi K, Nakano M, Ishida T Diseases. 2024; 12(6).

PMID: 38920554 PMC: 11202703. DOI: 10.3390/diseases12060122.

References

Okada T, Hamamoto S, Etani T, Naiki T, Sue Y, Banno R . Complete response of renal cell carcinoma with an inferior vena cava tumor thrombus and lung metastases after treatment with nivolumab plus ipilimumab. Int Cancer Conf J. 2020; 9(2):88-91. PMC: 7109205. DOI: 10.1007/s13691-020-00403-9. View

Okita K, Hatakeyama S, Naito S, Numakura K, Kato R, Koguchi T . External validation of the REMARCC model for the selection of cytoreductive nephrectomy in patients with primary metastatic renal cell carcinoma: A multicenter retrospective study. Urol Oncol. 2021; 39(12):836.e11-836.e17. DOI: 10.1016/j.urolonc.2021.08.015. View

Motzer R, Jonasch E, Agarwal N, Alva A, Baine M, Beckermann K . Kidney Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2022; 20(1):71-90. PMC: 10191161. DOI: 10.6004/jnccn.2022.0001. View

Ikarashi D, Kato Y, Katagiri H, Takahara T, Uesugi N, Shiomi E . Case of complete response to neoadjuvant therapy using nivolumab in a patient with metastatic renal cell carcinoma. Int J Urol. 2018; 25(6):630-632. DOI: 10.1111/iju.13590. View

Ljungberg B, Albiges L, Abu-Ghanem Y, Bedke J, Capitanio U, Dabestani S . European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update. Eur Urol. 2022; 82(4):399-410. DOI: 10.1016/j.eururo.2022.03.006. View

Okuno Y, Tanaka R, Mikami K, Takeuchi T . [Renal Cancer Tissue after Nivolumab/Ipilimumab Combination Therapy for Metastatic Renal Cell Carcinoma]. Hinyokika Kiyo. 2020; 66(1):13-17. DOI: 10.14989/ActaUrolJap_66_1_13. View

Rizzo A, Mollica V, Santoni M, Ricci A, Rosellini M, Marchetti A . Impact of Clinicopathological Features on Survival in Patients Treated with First-line Immune Checkpoint Inhibitors Plus Tyrosine Kinase Inhibitors for Renal Cell Carcinoma: A Meta-analysis of Randomized Clinical Trials. Eur Urol Focus. 2021; 8(2):514-521. DOI: 10.1016/j.euf.2021.03.001. View

Shirotake S, Kaneko G, Nagata K, Oyama M, Nishimoto K . Histological complete response with nivolumab for renal cell carcinoma with multiple metastases: A case report. Mol Clin Oncol. 2019; 10(2):244-248. PMC: 6327208. DOI: 10.3892/mco.2018.1779. View

Mollica V, Santoni M, Matrana M, Basso U, De Giorgi U, Rizzo A . Concomitant Proton Pump Inhibitors and Outcome of Patients Treated with Nivolumab Alone or Plus Ipilimumab for Advanced Renal Cell Carcinoma. Target Oncol. 2021; 17(1):61-68. DOI: 10.1007/s11523-021-00861-y. View

10.

Bhindi B, Graham J, Wells J, Bakouny Z, Donskov F, Fraccon A . Deferred Cytoreductive Nephrectomy in Patients with Newly Diagnosed Metastatic Renal Cell Carcinoma. Eur Urol. 2020; 78(4):615-623. DOI: 10.1016/j.eururo.2020.04.038. View

11.

El Husseini K, Piton N, De Marchi M, Gregoire A, Vion R, Blavier P . Lung Cancer Surgery after Treatment with Anti-PD1/PD-L1 Immunotherapy for Non-Small-Cell Lung Cancer: A Case-Cohort Study. Cancers (Basel). 2021; 13(19). PMC: 8508022. DOI: 10.3390/cancers13194915. View

12.

Smith A, Shah S, Rini B, Lieber M, Remer E . Morphology, Attenuation, Size, and Structure (MASS) criteria: assessing response and predicting clinical outcome in metastatic renal cell carcinoma on antiangiogenic targeted therapy. AJR Am J Roentgenol. 2010; 194(6):1470-8. DOI: 10.2214/AJR.09.3456. View

13.

Rizzo A, Mollica V, Santoni M, Massari F . Risk of selected gastrointestinal toxicities in metastatic renal cell carcinoma patients treated with immuno-TKI combinations: a meta-analysis. Expert Rev Gastroenterol Hepatol. 2021; 15(10):1225-1232. DOI: 10.1080/17474124.2021.1948328. View