gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Cytogenetic factors predicting the development of early brain metastases in renal cell carcinoma

Meeting Abstract

  • A. Gutenberg - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • M. Nschwitz - Pathologie, Universitätsklinikum Göttingen
  • C. Enders - Pathologie, Universitätsklinikum Göttingen
  • W. Brück - Neuropathologie, Universitätsklinikum Göttingen
  • L. Füzesi - Pathologie, Universitätsklinikum Göttingen
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum Göttingen

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.07-02

doi: 10.3205/09dgnc213, urn:nbn:de:0183-09dgnc2138

Published: May 20, 2009

© 2009 Gutenberg et al.
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Outline

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Objective: Brain metastases can develop as early and as late manifestation of renal cell cancer (RCC) and pose an increasing challenge as a result of the more frequent, prolonged survival of patients with advanced RCC. In fact, the time interval between primary diagnosis of RCC and occurrence of brain metastases is the most powerful prognostic factor for overall survival in patients with RCC. Our aim was to investigate genomic imbalance differences between primary RCC and brain metastases of RCC using comparative genomic hybridization (CGH) to identify chromosomal regions that may contain candidate genes important for the development of brain metastases and thus may have the potential to predict their occurrence early in the course of the disease.

Methods: We analyzed 181 RCC brain metastases of clear cell RCC and reviewed 189 primary clear cell RCC by using CGH.

Results: Patients developed brain metastases after a mean of 54.4 months. Median survival after surgery for brain metastases was 14.4 months. Most frequently, chromosomal aberrations in primary RCC were losses at 3p (74.6%), 14q (25.9%), and 8p (21.2%), and gains at 5q (42.3%), 7q (23.3), and 7p (18.0%). Brain metastases of RCC showed a significantly higher number of copy number changes with losses at 9q (46.7%) and 9p (45.3%) and gains at 5q (40.3%), 7p (32.6%), and 7q (30.4%). Gains at 17q21-25 lead to early manifestation of brain metastases already after 9 months; in contrast, losses at 9q33-34 delayed the occurrence of brain metastases to 59 months after diagnosis of RCC.

Conclusions: The present study provides the largest collection of molecularcytogenetically analyzed brain metastases of clear cell RCC. In general, brain metastases showed a higher amount of chromosomal copy number changes than the primary RCC. These differences were not only quantitative but also qualitative. Aberrations at 9q and 17q may harbour candidate genes important for the development of RCC brain metastases and might be used for predicting early or late development of brain metastases during the course of RCC.