Kroeger N, Gajda M, Zanow J, Petersen I, Settmacher U, Wunderlich H, Steiner T
Department of Urology, University Hospital, Jena, Germany. nils.kroeger @ med.uni-jena.de
Urol Int. 2010;84(4):479-84. doi: 10.1159/000296301. Epub 2010 Mar 17.
We report a treatment option in surgical therapy of locally advanced renal cell carcinoma (RCC).
A 63-year-old patient with locally advanced RCC including an atrial thrombus underwent 2 cycles of neoadjuvant therapy (Sutent 50 mg daily for 4 weeks followed by 2 weeks off) and then tumor surgery. Primary surgical therapy had to be delayed because of suspected bronchial carcinoma and additional diagnostics. After neoadjuvant therapy to downsize the tumor thrombus and exclusion of any additional malignant tumors, operation was done via abdominal access; no sternotomy was necessary.
Histopathological examinations of the primary tumor after tyrosine kinase inhibitor therapy were evaluated and compared to tumor biopsy material taken before therapy.
Neoadjuvant therapy with Sutent may represent a favorable treatment option in cases of locally advanced clear-cell RCC with extended tumor thrombus.
我们报告一种局部晚期肾细胞癌（RCC）手术治疗的方案。
一名63岁的局部晚期肾细胞癌患者，伴有心房血栓，接受了2个周期的新辅助治疗（舒尼替尼每日50毫克，持续4周，随后停药2周），然后进行肿瘤手术。由于怀疑患有支气管癌及进一步诊断，原手术治疗不得不推迟。在新辅助治疗使肿瘤血栓缩小且排除任何其他恶性肿瘤后，通过腹部入路进行手术；无需开胸。
对酪氨酸激酶抑制剂治疗后的原发性肿瘤进行组织病理学检查，并与治疗前采集的肿瘤活检材料进行比较。
对于伴有广泛肿瘤血栓的局部晚期透明细胞肾细胞癌病例，舒尼替尼新辅助治疗可能是一种有利的治疗选择。
