Staehler Michael, Schöppler Gita, Haseke Nico, Stadler Thomas, Karl Alexander, Siebels Michael, Ihrler Stephan, Stief Christian G
Department of Urology, University of Munich, Klinikum Grosshadern, Germany.
Clin Genitourin Cancer. 2009 Jan;7(1):58-61. doi: 10.3816/CGC.2009.n.010.
Carcinoma of the collecting ducts (CDC) of Bellini of the kidney is very rare but is among the most aggressive urologic entities.
Radical nephrectomy revealed CDC in stage pT3a pN2 M0 G3 in 2 male patients. Four courses of adjuvant chemotherapy with cisplatin and gemcitabine were given.
Subsequent restaging revealed local recurrence and lymph node metastases. Both patients were operated on again, and metastatic CDC was found. Second-line therapy with sunitinib was administered. After 2 cycles, multiple liver, lung, and bone metastases and mediastinal lymphopathy occurred. Eight weeks later, the patients died, with a survival of 8 months from initial diagnosis.
Nephrectomy, adjuvant gemcitabine/cisplatin, and sunitinib therapy did not alter the course of disease in these patients. Gross resection of disease was rapidly followed by local recurrence and, subsequently, widespread dissemination of disease. Clinical trial investigation is urgently needed because of the aggressive and refractory nature of CDC.
肾集合管癌（CDC）极为罕见，但却是最具侵袭性的泌尿系统疾病之一。
根治性肾切除术显示，2例男性患者的肿瘤分期为pT3a pN2 M0 G3的集合管癌。给予了4个周期的顺铂和吉西他滨辅助化疗。
随后的重新分期显示局部复发和淋巴结转移。两名患者均再次接受手术，发现有转移性集合管癌。给予舒尼替尼二线治疗。2个周期后，出现多处肝、肺和骨转移以及纵隔淋巴结病。8周后，患者死亡，从初诊起存活8个月。
肾切除术、辅助吉西他滨/顺铂治疗和舒尼替尼治疗并未改变这些患者的疾病进程。疾病大体切除后很快出现局部复发，随后疾病广泛播散。由于集合管癌具有侵袭性和难治性，迫切需要进行临床试验研究。
