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侵犯结肠的肾细胞癌的治疗:手术技术及系统评价

Management of colon-invading renal cell carcinoma: Operative technique and systematic review.

作者信息

Byrnes Kevin Gerard, Khan Jody Sultan Ali, Haroon Usman Muhammad, McCawley Niamh, Cheema Ijaz Ahmad

机构信息

Department of Urology, Beaumont Hospital, Dublin, Ireland.

Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland.

出版信息

Urol Ann. 2021 Jan-Mar;13(1):1-8. doi: 10.4103/UA.UA_86_20. Epub 2021 Jan 19.

DOI:10.4103/UA.UA_86_20
PMID:33897156
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8052896/
Abstract

Invasion into adjacent organs by non-metastatic renal cell carcinoma (RCC) occurs in 1% of patients suitable for resection. Colonic invasion is rare and presents technical challenges. No prospective data exists to guide management of these patients. We present the first reported case of a colon-invading RCC managed with simultaneous open right radical nephrectomy and extended right hemicolectomy. PubMed, Scopus and EMBASE databases were searched for relevant case reports reporting management of colon-invading renal cell carcinoma. Case reports, case series and cohort studies were eligible. A chart review was performed on a patient who presented with right-sided colon-invading RCC. Four previously reported cases were identified. The current case was managed with simultaneous open radical nephrectomy and extended right hemicolectomy. The patient remains well six months postoperatively with no evidence of disease recurrence. Histopathological evaluation of the resected specimen confirmed a T4 clear cell RCC with sarcomatoid differentiation. Colon-invading RCC is rare. This is the first reported case of right-sided, colon-invading RCC treated with radical resection. The current case confirms radical resection is a feasible management strategy for similar presentations. En bloc resection of involved organs remains the only potentially curative option for locally advanced disease.

摘要

非转移性肾细胞癌(RCC)侵犯相邻器官的情况在1%适合手术切除的患者中出现。侵犯结肠的情况罕见且存在技术挑战。目前尚无前瞻性数据来指导此类患者的治疗。我们报告首例经同时开放性右根治性肾切除术和扩大右半结肠切除术治疗的侵犯结肠的RCC病例。检索了PubMed、Scopus和EMBASE数据库,以查找有关侵犯结肠的肾细胞癌治疗的相关病例报告。病例报告、病例系列和队列研究均符合要求。对一名出现右侧侵犯结肠的RCC患者进行了病历回顾。共识别出4例先前报告的病例。本例患者接受了同时开放性根治性肾切除术和扩大右半结肠切除术。患者术后6个月情况良好,无疾病复发迹象。对切除标本的组织病理学评估证实为伴有肉瘤样分化的T4期透明细胞RCC。侵犯结肠的RCC很罕见。这是首例报告的经根治性切除治疗的右侧侵犯结肠的RCC病例。本例证实根治性切除是类似病例可行的治疗策略。整块切除受累器官仍然是局部晚期疾病唯一可能治愈的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/edb4e7fd8ae8/UA-13-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/85c64b3a97cf/UA-13-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/19fb5a34ef66/UA-13-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/4c4330adff02/UA-13-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/edb4e7fd8ae8/UA-13-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/85c64b3a97cf/UA-13-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/19fb5a34ef66/UA-13-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/4c4330adff02/UA-13-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d2/8052896/edb4e7fd8ae8/UA-13-1-g004.jpg

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