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Is there a place for radical nephrectomy in the presence of metastatic collecting duct (Bellini) carcinoma?
- Source :
-
The Journal of urology [J Urol] 2003 Apr; Vol. 169 (4), pp. 1287-90. - Publication Year :
- 2003
-
Abstract
- Purpose: We describe diagnostic and therapeutic characteristics, and long-term followup of collecting (Bellini) duct carcinoma.<br />Materials and Methods: Ten patients underwent surgery, including radical nephrectomy in 9 and partial nephrectomy in 1, for collecting duct carcinoma diagnosed by histological and immunohistochemical criteria.<br />Results: Collecting duct carcinoma, which represented 1.3% of renal cell carcinomas diagnosed between 1986 and 1999, developed at a mean patient age of 66.2 years (range: 50.7 to 81). It was detected clinically but never because of macroscopic hematuria. Mean tumor size was 94 mm. (range 30 to 150). Stage was pT3, pT2 and pT1 in 7, 1 and 2 cases, respectively. Seven patients had lymph node or extranodal metastases, and 8 and 2 had Fuhrman grades 3 and 4 disease, respectively. Eight patients died, including 3 early during the perioperative or postoperative period, which was attributable to major surgical difficulties associated with these invasive tumors. Two of the 3 patients who did not have metastases were alive 99 and 100 months after surgery, respectively. Median overall survival +/- SD was 9 +/- 6 and 6 +/- 8 months for patients with metastases. The all survival rate was 20% at 2 years.<br />Conclusions: Most collecting duct carcinomas are already metastatic at presentation. Because the prognosis is dismal despite radical nephrectomy, biopsy should be performed first when radiological findings are suggestive of collecting duct carcinoma. For metastatic collecting duct carcinoma radical nephrectomy alone does not seem to be useful except for palliative reasons or in the framework of new multicentric chemotherapy protocols in progress.
- Subjects :
- Aged
Aged, 80 and over
Carcinoma, Renal Cell mortality
Carcinoma, Renal Cell pathology
Female
Follow-Up Studies
France
Humans
Kidney Neoplasms mortality
Kidney Neoplasms pathology
Kidney Tubules, Collecting pathology
Male
Middle Aged
Neoplasm Staging
Survival Rate
Carcinoma, Renal Cell surgery
Kidney Neoplasms surgery
Kidney Tubules, Collecting surgery
Nephrectomy
Subjects
Details
- Language :
- English
- ISSN :
- 0022-5347
- Volume :
- 169
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 12629344
- Full Text :
- https://doi.org/10.1097/01.ju.0000050221.51509.f5