Nakagawa Takuya, Kawasaki Yoshihide, Sato Satoko, Katayama Hiromichi, Satake Yohei, Shimada Shuichi, Sato Takuma, Kawamorita Naoki, Yamashita Shinichi, Mitsuzuka Koji, Kohyama Atsushi, Ishida Masaharu, Ohtsuka Hideo, Unno Michiaki, Ito Akihiro
Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Pathology, Tohoku University Hospital, Sendai, Japan.
Case Rep Oncol. 2022 Nov 8;15(3):1014-1020. doi: 10.1159/000527089. eCollection 2022 Sep-Dec.
In a rare case, free from systemic therapy, deferred cytoreductive nephrectomy was implemented in treating an advanced renal cell carcinoma with liver, lung, and splenic colon metastases. A 59-year-old man diagnosed with advanced renal cell carcinoma underwent deferred cytoreductive nephrectomy due to a partial response to systemic treatment after a period of 1 year. After the surgery, no additional treatment was implemented. Furthermore, after 10 months, the patient had no recurrence of renal cell carcinoma. Through a review of this case and deferred cases in the current literature, we could emphasize the importance of image evaluation and pathological findings as an indication for surgery and subsequent treatment options. However, there is room for debate with regards to the indications for deferred cytoreductive nephrectomy as well as a therapeutic strategy after the surgery. This report discusses the significance of deferred cytoreductive nephrectomy in terms of prognosis and quality-of-life improvement in advanced renal cancer.
在一个罕见的病例中，对于一名患有肝、肺和脾结肠转移的晚期肾细胞癌患者，在未进行全身治疗的情况下实施了延期减瘤性肾切除术。一名59岁被诊断为晚期肾细胞癌的男性患者，在经过1年的全身治疗后出现部分缓解，随后接受了延期减瘤性肾切除术。术后未进行额外治疗。此外，10个月后，该患者的肾细胞癌未复发。通过回顾该病例以及当前文献中的延期病例，我们可以强调影像评估和病理结果作为手术指征及后续治疗选择的重要性。然而，关于延期减瘤性肾切除术的指征以及术后的治疗策略仍存在争议。本报告讨论了延期减瘤性肾切除术在晚期肾癌预后和生活质量改善方面的意义。
