Presurgical treatment with sunitinib for renal cell carcinoma with a level III/IV vena cava tumour thrombus
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Presurgical treatment with sunitinib for renal cell carcinoma with a level III/IV vena cava tumour thrombus. / Horn, T.; Thalgott, M. K.; Maurer, T.; Hauner, K.; Schulz, S.; Fingerle, A.; Retz, M.; Gschwend, J. E.; Kubler, H. R.
In: ANTICANCER RES, Vol. 32, No. 5, 05.2012, p. 1729-1735.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research
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TY - JOUR
T1 - Presurgical treatment with sunitinib for renal cell carcinoma with a level III/IV vena cava tumour thrombus
AU - Horn, T.
AU - Thalgott, M. K.
AU - Maurer, T.
AU - Hauner, K.
AU - Schulz, S.
AU - Fingerle, A.
AU - Retz, M.
AU - Gschwend, J. E.
AU - Kubler, H. R.
N1 - 1791-7530 Horn, Thomas Thalgott, Mark K Maurer, Tobias Hauner, Katharina Schulz, Stephan Fingerle, Alexander Retz, Margitta Gschwend, Jurgen E Kubler, Hubert R Journal Article Greece Anticancer Res. 2012 May;32(5):1729-35.
PY - 2012/5
Y1 - 2012/5
N2 - AIM: The feasibility and safety of a presurgical treatment approach with sunitinib for renal cell carcinoma (RCC) with level III/IV tumour thrombus in the inferior vena cava (IVC) were to be evaluated and its potential ability to reduce the surgical morbidity explored.PATIENTS AND METHODS: In our institution, we treated five consecutive patients with suspected RCC and a level III/IV IVC tumour thrombus with preoperative sunitinib (50 mg, 4 weeks on, 2 weeks off). Side dose effects were assessed and the effect on the tumour size and the dependent surgical approach documented with a computed tomographic scan before and after the treatment. The data were analyzed retrospectively.RESULTS: The overall tolerability to presurgical sunitinib was good. All procedures were carried out without perioperative complications. In four patients, a reduction in tumour size was observed, which resulted in avoidance of a bicavital surgical approach with cardiopulmonary bypass in one patient. This patient was diagnosed with papillary renal cancer; the other four patients had clear cell carcinomas.CONCLUSION: Presurgical treatment with sunitinib is able to ease surgery for RCC tumour thrombi regardless of the histological subtype in selected patients. In our series, surgery was possible without additional morbidity. Two courses of a presurgical therapy with sunitinib seems to be an appropriate duration. In accordance with previously published data, presurgical sunitinib treatment may become more widely used in RCC with level III/IV IVC tumour thrombi but administered with restraint in cases of level I/II thrombi. The effects on the risk of recurrence and survival remain to be evaluated prospectively.
AB - AIM: The feasibility and safety of a presurgical treatment approach with sunitinib for renal cell carcinoma (RCC) with level III/IV tumour thrombus in the inferior vena cava (IVC) were to be evaluated and its potential ability to reduce the surgical morbidity explored.PATIENTS AND METHODS: In our institution, we treated five consecutive patients with suspected RCC and a level III/IV IVC tumour thrombus with preoperative sunitinib (50 mg, 4 weeks on, 2 weeks off). Side dose effects were assessed and the effect on the tumour size and the dependent surgical approach documented with a computed tomographic scan before and after the treatment. The data were analyzed retrospectively.RESULTS: The overall tolerability to presurgical sunitinib was good. All procedures were carried out without perioperative complications. In four patients, a reduction in tumour size was observed, which resulted in avoidance of a bicavital surgical approach with cardiopulmonary bypass in one patient. This patient was diagnosed with papillary renal cancer; the other four patients had clear cell carcinomas.CONCLUSION: Presurgical treatment with sunitinib is able to ease surgery for RCC tumour thrombi regardless of the histological subtype in selected patients. In our series, surgery was possible without additional morbidity. Two courses of a presurgical therapy with sunitinib seems to be an appropriate duration. In accordance with previously published data, presurgical sunitinib treatment may become more widely used in RCC with level III/IV IVC tumour thrombi but administered with restraint in cases of level I/II thrombi. The effects on the risk of recurrence and survival remain to be evaluated prospectively.
KW - Angiogenesis Inhibitors
KW - Antineoplastic Agents
KW - Carcinoma, Renal Cell
KW - Humans
KW - Indoles
KW - Kidney Neoplasms
KW - Neoplastic Cells, Circulating
KW - Pyrroles
KW - Sunitinib
KW - Vena Cava, Inferior
KW - Venous Thrombosis
KW - Journal Article
M3 - SCORING: Journal article
C2 - 22593453
VL - 32
SP - 1729
EP - 1735
JO - ANTICANCER RES
JF - ANTICANCER RES
SN - 0250-7005
IS - 5
ER -