Cytoreductive Nephrectomy in Metastatic Kidney Cancer: Experience of the Urology Department at Aristide Le Dantec University Teaching Hospital

Abstract

Aim: to assess the place of cytoreductive nephrectomy in the management of metastatic kidney cancer in our daily practice. Patients and methods: This was a retrospective, descriptive and analytical study from January 2010 to December 2014 on patients aged 18 years and over operated for metastatic kidney cancer. The variables studied were prognostic: Performance Status, tumor stage, sites and number of metastatic sites, prognosis group according to Heng's model, histological type and Furhman grade of the nephrectomy specimen, follow-up postoperative course and overall survival. Results: A total of 12 patients were included. The mean size of the largest axis of the tumors was 14.06 ± 5.3 cm with extremes of 8.2 and 23.8 cm and the tumor was graded T3 in 6 cases. The majority of patients had a single metastatic site and the lung was the most common metastatic site in 9 cases. In half of the cases the ECOG-PS score was 1. In 6 cases the patients were classified in the Heng intermediate prognosis group. Lymph node dissection was associated with nephrectomy in 4 cases. Renal adenocarcinoma was the most common histologic type in 8 cases and Furhman's grade was only specified in 6 cases. The mean duration of follow-up was 10.1 ± 13.4 months (range 1 and 39 months), overall survival at 2 years was poor and only 2 patients were alive 3 years and 4 years after their nephrectomy. Conclusion: Metastatic kidney cancer is uncommon in our context; most of our patients consult with advanced stage tumors. Systemic treatment remains difficult for our populations to access. Nephrectomy remains the main weapon at our disposal.