Collecting (Bellini) duct carcinoma: A clinical study of a rare tumour and review of the literature.

Abstract

We report our 15-year experience of Collecting (Bellini) duct carcinoma (CDC). We retrospectively analyzed patient and tumour characteristics, clinical manifestations, surgical techniques, clinical outcomes, and salvage therapies. From January 1999 to December 2013, 1042 patients underwent surgical resection of renal neoplasm. We examined all renal tumors and identified 10 cases (0.96%) of CDC. The study group included 8 men and 2 women, with a median age of 62.5 years. Of these 10 patients, 9 were symptomatic (90%). All patients were treated with open nephrectomy. The mean tumour size was 5.7 cm. The pathologic stages were distributed as follows: pT1b in 2 patients (20%); pT2a in 1 patient (10%); pT3a in 3 patients (30%); and pT3b in 4 patients (40%). Grading was assessed according to Fuhrman scale as follows: grade II in 1 patient (10%); grade III in 3 patients (30%); grade IV in 5 patients (50%); undetermined grade in 1 patient (10%). Four patients (40%) relapsed locally. The median time of local recurrence was 4.9 months. Distant metastases occurred in 9 patients (90%): 4/9 at the time of diagnosis and 5/9 after nephrectomy. The median time of distant metastases after surgery was 8.1 months. Six patients received chemotherapy (gemcitabine plus platinum salts). Radiotherapy was performed in 5 patients. One patient had surgery because of local recurrence and 2 patients were irradiated in the area of the local recurrence. The median overall survival was 7.6 months, and only 2 patients survived more than 2 years after the nephrectomy. CDCs of the kidney are aggressive and they have a low survival rate. All patients in our study experienced a relapse of their disease. Local recurrence preceded distant metastases. Results of salvage treatments were poor.