肾集合管癌的治疗：系统评价和麦克马斯特大学的经验。
Management of renal collecting duct carcinoma: a systematic review and the McMaster experience.
机构信息
Division of Urology, Department of Surgery, McMaster University, Hamilton, ON.
出版信息
Curr Oncol. 2013 Jun;20(3):e223-32. doi: 10.3747/co.20.1230.
INTRODUCTION
Collecting duct carcinoma (cdc) is a rare, aggressive form of renal carcinoma that presents at an advanced stage and has a poor prognosis. Little is known concerning the optimal management of cdc. We present the results of a systematic review addressing the management of cdc and the McMaster University cdc series.
METHODS
The medline, Cochrane Library, and embase databases and conference proceedings were searched to identify studies relating to the management of cdc. Included studies reported on a minimum of 10 subjects receiving a single intervention. Series in which an evaluation of therapeutic effectiveness was not possible were excluded. The McMaster University (Hamilton, Ontario) series of 6 cases of cdc were retrospectively reviewed.
RESULTS
We identified 3 studies relevant to the management of cdc that included a total of 72 patients. A gemcitabine-cisplatin or -carboplatin regimen resulted in a 26% objective response rate in 23 patients with metastatic cdc. Two additional studies indicated that 49 patients treated with immunotherapy achieved no response. In the McMaster series, cytoreductive nephrectomy was performed in 4 of 6 patients. In 2 patients, mvac therapy (methotrexate-vinblastine-doxorubicin-cisplatin) achieved no response. No significant therapeutic complications occurred, but survival was poor (median: 11 months; range: 10-33 months).
CONCLUSIONS
Our review and clinical experience suggest that the current standard of care for metastatic cdc is a gemcitabine-cisplatin regimen.
简介
集合管癌（cdc）是一种罕见且侵袭性的肾细胞癌，通常在晚期出现，预后较差。目前对于 cdc 的最佳治疗方法知之甚少。我们报告了一项系统评价的结果，该评价旨在探讨 cdc 的治疗方法以及麦克马斯特大学 cdc 系列。
方法
检索了 medline、Cochrane 图书馆、embase 数据库和会议论文集，以确定与 cdc 治疗相关的研究。纳入的研究报告了至少 10 例接受单一干预的患者。排除了无法评估治疗效果的系列研究。回顾性分析了麦克马斯特大学（安大略省汉密尔顿）的 6 例 cdc 系列病例。
结果
我们确定了 3 项与 cdc 治疗相关的研究，共纳入了 72 例患者。在 23 例转移性 cdc 患者中，吉西他滨-顺铂或卡铂方案的客观缓解率为 26%。另外两项研究表明，49 例接受免疫治疗的患者没有反应。在麦克马斯特系列中，4 例患者接受了减瘤性肾切除术。在 2 例患者中，mvac 治疗（甲氨蝶呤-长春碱-多柔比星-顺铂）没有反应。没有发生显著的治疗并发症，但生存情况较差（中位数：11 个月；范围：10-33 个月）。
结论
我们的回顾和临床经验表明，转移性 cdc 的当前标准治疗方法是吉西他滨-顺铂方案。
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