Peyromaure Michaël, Thiounn Nicolas, Scotté Florian, Vieillefond Annick, Debré Bernard, Oudard Stéphane
Department of Urology, Cochin Hospital, Paris, France.
J Urol. 2003 Oct;170(4 Pt 1):1138-40. doi: 10.1097/01.ju.0000086616.40603.ad.
Collecting duct carcinoma (CDC) of the kidney is a rare variant that is associated with an extremely poor prognosis. We report our experience with this variety of cancer in the last 9 years.
From 1993 to 2002, 9 patients with CDC were treated at our institution. The diagnosis of CDC was made by a nephrectomy specimen in 8 cases and by renal biopsy in 1. Tumor characteristics, and patient treatment and outcome are reported.
At presentation 1 T1N0M0, 1 T3N0M0, 3 T3N+M0 and 4 T3N+M+ tumors were seen. Mean followup was 13.6 months. Five patients received no complementary treatment. The patient with the T1N0M0 tumor remained free of disease 13 months after nephrectomy and the one with T3N0M0 tumor remained free of disease at 17 months. A patient with a T3N+M+ tumor experienced progression at 1 month, local recurrence at 17 months and was then lost to followup. The 2 other patients with T3N+M0 and T3N+M+ disease, respectively, progressed rapidly and were lost to followup after 5 months. One patient with a T3N+M0 neoplasm received immunotherapy and died after 24 months, while the other with T3N+M0 disease was treated with oral prednisolone and died after 5 months. Finally, 2 patients with T3N+M+ disease received chemotherapy, consisting of 1,250 mg/m2 gemcitabine on days 1 and 8, and 70 mg/m2 cisplatin on day 1. Each patient achieved an objective response after 3 chemotherapy cycles and remained disease-free 27 and 9 months after nephrectomy, respectively.
CDC is an aggressive variety of kidney neoplasm that is often associated with nodal and visceral metastases at presentation. Our data suggest that combined gemcitabine and cisplatin chemotherapy may be the best therapeutic option for patients with this tumor.
肾集合管癌（CDC）是一种罕见的变异型肿瘤，预后极差。我们报告过去9年中诊治这种癌症的经验。
1993年至2002年，我们机构共治疗了9例CDC患者。8例患者通过肾切除标本确诊，1例通过肾活检确诊。报告了肿瘤特征、患者治疗情况及预后。
初诊时，可见1例T1N0M0、1例T3N0M0、3例T3N+M0和4例T3N+M+肿瘤。平均随访时间为13.6个月。5例患者未接受辅助治疗。T1N0M0肿瘤患者肾切除术后13个月无疾病复发，T3N0M0肿瘤患者17个月无疾病复发。1例T3N+M+肿瘤患者1个月时病情进展，17个月时局部复发，随后失访。另外2例分别为T3N+M0和T3N+M+疾病患者病情迅速进展，5个月后失访。1例T3N+M0肿瘤患者接受免疫治疗，24个月后死亡，另1例T3N+M0疾病患者接受口服泼尼松龙治疗，5个月后死亡。最后，2例T3N+M+疾病患者接受化疗，第1天和第8天给予吉西他滨1250mg/m²，第1天给予顺铂70mg/m²。每位患者化疗3个周期后均获得客观缓解，肾切除术后分别无疾病复发27个月和9个月。
CDC是一种侵袭性肾肿瘤，初诊时常伴有淋巴结和内脏转移。我们的数据表明，吉西他滨和顺铂联合化疗可能是该肿瘤患者的最佳治疗选择。
