SURGICAL MANAGEMENT OF BRAIN METASTASES FROM RENAL CELL CARCINOMA

  • Anca Buliman 1Bagdasar Arseni Clinical Emergency Hospital 2Faculty of Medicine, Titu Maiorescu University
  • Tabita Larisa Cazac 2Faculty of Medicine, Titu Maiorescu University 3The University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
  • N. Marandici 1Bagdasar Arseni Clinical Emergency Hospital
  • F. Brehar 2Faculty of Medicine, Titu Maiorescu University 3The University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
  • R.M. Gorgan 2Faculty of Medicine, Titu Maiorescu University 3The University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
Keywords: renal cell carcinoma, brain metastases, neurosurgery, stereotactic radiosurgery, whole brain radiation therapy

Abstract

Treatment options such as microneurosurgery and stereotactic radiosurgery (SRS) are now available for brain metastases originating from renal cell carcinoma (BMRCC) and an aggressive approach is indicated in selected patients to improve both survival and quality of life. Patients undergoing evaluation and treatment for BMRCC from 2010 to 2019 were retrospectively reviewed. Patient characteristics, surgical treatment, outcome and survival were analyzed. A total of 69 patients were included in this study, of whom 75% had clear cell carcinoma and 75% had synchronous extracranial metastases. Treatment included: surgery alone – 13%, surgery plus whole brain radiation therapy (WBRT) – 59.4%, surgery plus SRS – 5.8%, WBRT alone – 13% and SRS alone – 8.7%. CNS recurrences were demonstrated in 52.2% of cases. The median overall survival after diagnosis of BMRCC was 11.6 months, with a median overall survival of 14 months for the patients who underwent neurosurgery. For all patients, the 1-year and 2-year overall survival rates were 59.4% and 15.9%, respectively. For surgically treated patients, 1-year and 2-year overall survival rates were 73.9% and 17.4%, respectively. In our study, only the Karnofsky performance status on admission appeared to have an independent impact on overall survival. A multidisciplinary approach of patients with BMRCC, combining nephrectomy, metastasectomy and/or radiotherapy with systemic targeted therapy, may prolong survival and quality of life. Neurosurgical opinion is important in determining optimal treatment.

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Published
2019-12-30
How to Cite
Buliman, A., Cazac, T., Marandici, N., Brehar, F., & Gorgan, R. (2019). SURGICAL MANAGEMENT OF BRAIN METASTASES FROM RENAL CELL CARCINOMA. Romanian Journal of Clinical Research, 2(2). Retrieved from https://rjcronline.com/index.php/rjcr/article/view/35
Section
Articles