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肾集合管癌。4例新病例报告。

Collecting duct carcinoma of the kidney. A contribution of 4 new cases.

作者信息

Soto Delgdo Manuel, Pedrero Márquez Gema, Arroyo Maestre Jose Miguel, Beardo Villar Pastora

机构信息

Urology Department y Unidad de Enfermería. Hospital de Jerez de la Frontera. Cádiz. Spain.

出版信息

Arch Esp Urol. 2014 Oct;67(8):714-7.

Abstract

OBJECTIVE

Collecting duct carcinoma of the kidney is a rare and aggressive subtype of renal cell carcinoma with low cancer-specific survival. We reviewed our series of collecting duct tumours retrospectively.

METHODS/RESULTS: We performed a retrospective analysis of the collecting duct carcinomas of the kidney treated in our unit between January 2007 and December 2012. The variables analysed were: age, gender, reason for consultation, side affected, ASA score according to anaesthetic risk, surgical treatment, tumour size, Fuhrman grade, lymphovascular invasion, TNM staging (2009 classification), adjuvant treatment and survival time. Four collecting duct carcinomas were identified. Mean patient age was 61 years. Constitutional syndrome and lower back pain were the most frequent reasons for consultation (75%), followed by hematuria. The surgical treatment was laparoscopic radical nephrectomy in 100% of the cases, with lymphadenectomy in 2 patients due to lymph node disease detected on imaging studies. The 4 patients were initially treated with temsirolimus as adjuvant therapy with no response. Two patients were given second-line treatment with sunitinib without any response. All 4 patients died from their disease with a mean survival of 9.5 months (rang: 4-15 months).

CONCLUSIONS

Collecting duct carcinoma of the kidney is a rare and aggressive renal parenchymal tumour. Long-term survival rate is low, because the only potentially curative treatment seems to be surgery if it is performed in patients with localised tumours.

摘要

目的

肾集合管癌是肾细胞癌中一种罕见且侵袭性强的亚型,癌症特异性生存率低。我们对我们系列的集合管肿瘤进行了回顾性研究。

方法/结果:我们对2007年1月至2012年12月在我们科室治疗的肾集合管癌进行了回顾性分析。分析的变量包括:年龄、性别、就诊原因、患侧、根据麻醉风险的美国麻醉医师协会(ASA)评分、手术治疗、肿瘤大小、富尔曼分级、脉管侵犯、TNM分期(2009年分类)、辅助治疗和生存时间。共识别出4例肾集合管癌。患者平均年龄为61岁。全身症状和下背部疼痛是最常见的就诊原因(75%),其次是血尿。100%的病例手术治疗为腹腔镜根治性肾切除术,2例因影像学检查发现淋巴结病变而行淋巴结清扫术。4例患者最初接受坦西莫司辅助治疗,无反应。2例患者接受舒尼替尼二线治疗,无任何反应。4例患者均死于疾病,平均生存时间为9.5个月(范围:4 - 15个月)。

结论

肾集合管癌是一种罕见且侵袭性强的肾实质肿瘤。长期生存率低,因为如果对局限性肿瘤患者进行手术,似乎是唯一可能治愈的治疗方法。

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