Twenty-year survival after iterative surgery for metastatic renal cell carcinoma: A case report and review of literature

作     者：Emilio De Raffele Mariateresa Mirarchi Riccardo Casadei Claudio Ricci Eugenio Brunocilla Francesco Minni 

作者机构：Dipartimento dell'Apparato DigerentePoliclinico S.Orsola-MalpighiUniversity of BolognaBologna 40138Italy Dipartimento Strutturale ChirurgicoOspedale SS Antonio e MargheritaTortona(AL)15057Italy Dipartimento di Scienze Mediche e Chirurgiche(DIMEC)Alma Mater StudiorumPoliclinico S.Orsola-MalpighiUniversity of BolognaBologna 40138Italy Dipartimento di Medicina SpecialisticaDiagnostica e Sperimentale(DIMES)Alma Mater StudiorumPoliclinico S.Orsola-MalpighiUniversity of BolognaBologna 40138Italy 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2020年第8卷第19期

页      面：4450-4465页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Renal cell carcinoma Metastases Surgery Thermal ablation Radiation Case report Systemic therapy 

摘      要：BACKGROUND The therapeutic approach of metastatic renal cell carcinoma(RCC)represents a real challenge for clinicians,because of the variable clinical course;the recent availability of numerous targeted therapies that have significantly improved overall oncological results,but still with a low percentage of complete responses;and the increasing role of metastasectomy(MSX)as an effective strategy to achieve a durable cure,or at least defer initiation of systemic therapies,in selected patients and in the context of multimodality treatment ***^E SUMMARY We report here the case of a 40-year-old man who was referred to our unit in November 2004 with lung and mediastinal lymph nodes metastases identified during periodic surveillance 6 years after a radical nephrectomy for RCC;he underwent MSX of multiple lung nodules and mediastinal lymphadenectomy,with subsequent systemic therapy with Fluorouracil,Interferon-alpha and Interleukin *** subsequent clinical course was characterized by multiple sequential abdominal and thoracic recurrences,successfully treated with multiple systemic treatments,repeated local treatments,including two pancreatic resections,conservative resection and ablation of multiple bilobar liver metastases,resection and stereotactic body radiotherapy of multiple lung *** is alive without evidence of recurrence 20 years after initial nephrectomy and sequential treatment of recurrences in multiple sites,including resection of more than 38 metastases,and 5 years after his last *** This case highlights that effective multimodality therapeutic strategies,including multiple systemic treatments and iterative aggressive surgical resection,can be safely performed with long-term survival in selected patients with multiple metachronous sequential metastases from RCC.