Multi - target therapy with operation for the treatment of bilateral renal cell carcinoma

Abstract

Objectives To introduce our successful experience on treating synchronous bilateral renal cell carcinoma( BRCC)with operation and multi - target drug.Methods From Jan 2011 to Dec 2011,3 cases of BRCC were treated by multi - target drug(Sunitinib) combined with operation in our institute.There were 2 males and 1 females with the average age of 48 years old( ranging from 40 to 59 years old).Two cases were found bilateral renal tumor during annual physical examination,while 1 case complained of sore waist.All cases were confirmed by ultrasounography and CT scan pre - operatively.Among the 3 cases,3 tumors were located at the upper pole of kidney,1 at the middle and 2 at the lower pole.Three tumors were on the left kidney,3 on the tight side.The mean tumor size was 3.5 cm in diameter( 2.0 ～ 5.5 cm).All of the 3 cases underwent bilateral nephron sparing surgery(NSS) with an interval of 8 to 10 weeks.Sunitinib were administrated during the intervals.Results NSS was successfully performed in all 3 cases with no blood transfusion.The estimated blood loss ranged from 200 ～ 400ml.The pathologic findings of all 6 tumors were clear cell carcinoma.After taking sunitinib during intervals,all tumors volume decreased at a certain degree.No case suffered urinary fistula,bleeding,or infection postoperatively.Local recurrence or distal metastasis were not observed during a mean follow - up period of 9 months(5 ～ 11 months).Conclusions Targeted drug - assisted NSS treatment for the synchronous bilateral renal cell carcinoma could reduce the tumor stage and increase the success rate of NSS.Furthermore,this method could allow NSS treatment in patients deemed to receive radical nephrectomy. Key words: Kidney Neoplasms; Drug Carriers