Ces Urol 2005, 9(3):26-30 | DOI: 10.48095/cccu2005018

Results of onco-urology treatment in late renal carcinoma

I. Kawaciuk¹, P. Dušek¹, L. Hyršl¹, L. Jarolím¹, R. Pospíšil², M. Schmidt¹, V. Kaliská¹, M. Chocholatý¹, M. Urbanová¹

¹ Urologická klinika 2. LF UK a FN Motol, Praha

² I. chirurgická klinika 2. LF UK a FN Motol, Praha

Between 1999 and 2003, 61 patients (40 men and 21 women - average age 58,5 years) were treated for advanced renal cell carcinoma in the Department of Urology, 2nd Faculty of Medicine, Faculty Hospital Motol. Adjuvant therapy was administered in 22 patients (13 men and 9 women -average age 55,1 years) after radical nephrectomy for renal cell carcinoma without documented metastatic disease but with high risk of relapse. Nineteen patients received monotherapy IFN-alpha 5 MIU/m2/day three times per week for 6-12 months and three patients immunochemotherapy (IFN-alpha + IL-2 + 5-FU). Median survival was 34,5 months (15-65) at median follow- up (< 65 months). Median recurrence free period was 33 months (9-65). Three patients with sarcomatoid type clear cell carcinoma relapsed in 9, 9 and 12 months. Adjuvant therapy did not affect poor prognosis of sarcomatoid tumors. Multicentric studies proved no impact on prognosis in other risk tumors.
Thirty nine patients with metastatic tumor (27 men and 12 women - average age 60,4 years) received monotherapy IFN-alpha or immunochemotherapy (IFN-alpha + IL-2 + 5-FU). Median overall survival was 16 months (4-60). The median survival in the group of 17 patients without metastasectomy was 15 months. Five patients (29,4%) had objective response with median duration 13 months (9-50). Two patients (11,8%) had complete response 50 and 9 months and three (17,6%) had a partial response with median 9 months (9-17). The median survival in the group of 22 patients with metastasectomy was 17 months. Median to progression was 13 months (3-63).
There was no significant difference (p = 0,61) in overall survival of patients with metastatic renal cell carcinoma with or without metastasectomy. Aggresive surgery and oncological therapy is profitable only for very small group of patients with advanced renal cell carcinoma, which we are not able to define before.

Keywords: advanced renal cell carcinoma, prognosis, adjuvant therapy, metastasectomy, immunochemotherapy

Published: June 1, 2005