Artikel
Clinical outcome of patients with metastatic papillary renal cell carcinoma
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Autoren
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Thomas Steiner
- Klinik und Poliklinik für Urologie, Friedrich-Schiller-Universität Jena, Deutschland
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Jan Roigas
- Klinik und Poliklinik für Urologie der Humbold-Universität Berlin, Campus-Charite´-Mitte
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Hartmut Kirchner
- Klinik für Innere Medizin, Kliniken Hannover - Krankenhaus Siloah
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Christian Doehn
- Klinik und Poliklinik für Urologie am Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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Hans Heynemann
- Klinik und Poliklinik für Urologie der Martin-Luther-Universität Halle/Wittenberg
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Zoltan Varga
- Klinik und Poliklinik für Urologie, Phillips-Universität Marburg
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Detlef Rohde
- Klinik für Urologie, Kliniken Darmstadt
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Michael Siebels
- Klinik und Poliklinik für Urologie der Ludwig-Maximilians-Universität München
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Jörg Schubert
- Klinik und Poliklinik für Urologie, Friedrich-Schiller-Universität Jena
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Stefan Loening
- Klinik und Poliklinik für Urologie der Humbold-Universität Berlin, Campus-Charite´-Mitte
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Dieter Jocham
- Klinik und Poliklinik für Urologie am Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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Paolo Fornara
- Klinik und Poliklinik für Urologie der Martin-Luther-Universität Halle/Wittenberg
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Rainer Hofmann
- Klinik und Poliklinik für Urologie, Phillips-Universität Marburg
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Christian Stief
- Klinik und Poliklinik für Urologie der Ludwig-Maximilians-Universität München
| Veröffentlicht: | 20. März 2006 |
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Gliederung
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Objective: For a long time it has been discussed, whether patients (pts.) with metastasized papillary renal cell carcinoma (mRCC pap) show special behaviour regarding the response to immuno(chemo)therapeutic options and over-all survival.
Methods: Clinical data of 59 pts. with mRCC pap were assessed at 8 treatment centres retrospectively.
Results: Median follow-up was 20 (1 – 114) months, median age at time of diagnosis was 62 (24-85) years. Men were affected predominantly (49 out of 59; 83%). 21 pts. (36%) showed metastases at time of diagnosis. In the remaining 38 pts. with metachroneous metastatic disease mean time to development of metastases was 32 (3 – 143; median 18.5) months. Sites of metastases were: pulmonary (37; 63%), osseous (24; 41%), hepatic (20; 33%), lymphatic (12; 37%). Local recurrences occurred in 17 pts. (29%). Others sites of disease were brain mts. in 6 pts. (10%), peritoneal carcinosis in 4 pts. (7%) and others. A surgical approach was performed primarily in 9 pts. (15%): pulmo 2; local recurrence and lymphomas 5; liver 1; brain 1. 26 pts. received an immuno- (interferon-a +/- interleukin-2) or immunochemotherapy (in combination with vinblastine or 5-fluorouracile) as first line treatment for metastatic disease. Overall 40 out of 59 pts. (68%) received an interferon- or interleukin-based immunotherapy. No treatment at all was performed in 12 pts. (20%) because of poor performance status. 5 out of 40 pts. (12.5%) achieved an objective response to immuno(chemo)therapy. In the Kaplan-Meier-analysis, median overall survival after diagnosis of metastatic disease was assessed to be 13 +/- 1.5 (95% Ci 9.9-16) months.
Conclusions: Clinical data of a larger population of pts. with mRCC pap have been assessed in this retrospective study for the first time. Compared to pts. with clear cell mRCC, these patients are characterized by: I) more frequent local recurrences; II) low remission rates on immuno(chemo)therapeutic approaches; III)poor prognosis regarding overall survival.
