演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

分子標的薬登場以降の下大静脈腫瘍塞栓を伴う腎細胞癌症例の治療成績

演題番号 : P34-5

[筆頭演者]
演者)今村 有佑:1 
[共同演者]
山本 賢志:1、佐塚 智和:1、仲村 和芳:1、坂本 信一:1、川村 幸治:1、今本 敬:1、小宮 顕:1、市川 智彦:1

1:千葉大学・泌尿器科

 

[Objectives] According to the kidney cancer guidelines in Japan, renal cell carcinoma (RCC) extending into inferior vena cava, cytoreductive nephrectomy is recommended grade C1 in patients with locally advanced RCC without metastasis, whereas in cases with metastases there is no clear evidence for surgery. The treatment outcomes of RCC extending into inferior vena cava cases in the era of molecular targeted drugs were examined.
[Methods] Twenty-nine cases were diagnosed and treated as RCC with inferior vena cava in Chiba University hospital from December 2008 to January 2018. In patients with good Performance status (PS) without uncontrollable metastasis, patients underwent immediate surgery and patients with poor PS or with difficulty in surgery introduced molecular targeted drug therapy after percutaneous needle biopsy.
[Results] Patient background was 21 males and 8 females. The median age was 68 years, the tumor was 22 cases on the right and 7 cases on the left. Risk classification was 20 cases of Intermediate risk and 9 cases of Poor risk. Histopathological findings were 21 cases of clear cell carcinoma, 4 other cases, 4 cases of unknown. In stage classification, N 1/2 was 4/5 cases and M1 was 20 cases. The Neves classification, level 1/2/3/4 was 7/16/4/2 respectively. Immediate surgery was performed in 14 cases, the remaining 15 patients were treated with molecular targeted drugs, and one patient underwent surgery later. In 4 of 15 patients who underwent molecular targeted drugs, embolic level was reduced. In the M1 cases, the surgical group had a median survival time of 32.6 months, the non-operative group was 17.3 months, the surgical group had a long-term survival trend but there was no statistically significant.
[Conclusions] The significance of a multidisciplinary treatment strategy was suggested including metastatic lesions with administration of molecular targeted drugs considering cytoreductive nephrectomy.

キーワード

臓器別:腎・尿路・膀胱

手法別:集学的治療

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