Neoadjuvant targeted therapy in a primary metastasized renal cell cancer patient leads to down-staging of inferior vena cava thrombus (IVC) ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-02

AUTHORS

Inga Peters, Michael Winkler, Björn Jüttner, Omke E. Teebken, T. R. Herrmann, Christoph von Klot, Mario Kramer, Angela Reichelt, Mahmoud Abbas, Markus A. Kuczyk, Axel S. Merseburger

ABSTRACT

BACKGROUND: We report on a 62-year-old gentleman presenting at our urological department with an advanced renal cell cancer of the right kidney (10 cm in diameter), with an extensive caval vein thrombus (level IV) and bilateral pulmonary metastases. Another suspicious lesion at the left hemithorax was radiologically described. METHOD: A presurgical, neoadjuvant systemic therapy with sunitinib, a tyrosine kinase inhibitor, was initiated for 4 cycles in total (50 mg/day; 4 weeks on/2 weeks off). The cytoreductive nephrectomy was performed following the fourth cycle of sunitinib and after a 14-day break. Transesophageal echocardiography was used for intraoperative monitoring of the caval vein thrombus. Systemic treatment with sunitinib was continued 4 weeks after surgery. RESULTS: A significant reduction in tumor size, metastatic sites and down-staging of IVC from level IV to level III according to Novick classification was achieved. CONCLUSION: Significant down-staging of the tumor caval vein thrombus which initially reached the right atrium enabled us to perform surgery limited to the abdominal cavity without extracorporeal circulation nor hypothermia. More... »

PAGES

245-248

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-012-0955-5

DOI

http://dx.doi.org/10.1007/s00345-012-0955-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1004226805

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23053210


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