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MINERVA UROLOGICA E NEFROLOGICA

Rivista di Nefrologia e Urologia


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Minerva Urologica e Nefrologica 2017 April;69(2):166-72

DOI: 10.23736/S0393-2249.16.02809-5

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

The treatment of vertebral metastases from renal cell carcinoma: a retrospective study

Giulia R. MOSELE 1 , Gianfilippo CAGGIARI 1, Roberto M. SCARPA 2, Carlo DORIA 1

1 Orthopaedic Department, University of Sassari, Sassari, Italy; 2 Department of Oncology, University of Turin, Turin, Italy


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BACKGROUND: Renal cell carcinoma (RCC) is among the ten most common cancers in both men and women. It comprises 2-3% of all malignancies. The most common site for metastasis from RCC is the lung (50% of patients), followed by the skeleton (20% to 50% of patients).
METHODS: We retrospectively reviewed our consecutive series of 63 patients surgically treated for spinal metastases from RCC. The surgical treatment for spinal metastases varied in each patient. Factors influencing the choice of surgery included age, disease status, symptoms, morbidity of the patient, the location, the number of repetitive lesions and the existence of extra-osseous metastases. For 42 patients (66.66%) the treatment included radiation two weeks after the surgical procedure.
RESULTS: A total of 68 surgical procedures were performed in 63 patients. For all patients we collected data about type of RCC, locations of metastasis, type of spine metastasis, type of surgery and complications. In this way we had an exahustive vision of the natural history of this kind of patients.
CONCLUSIONS: Spine metastatic RCC has a poor prognosis. The favorable prognostic factor is solitary spinal metastasis without involvement of visceral organs where the gold standard treatment is corpectomy en bloc. The negative prognostic factors are the presence of one or more pathological fractures and neurological deficits. Bisphosphonate as zoledronic acid reduce significantly skeletal morbidity and significantly prolong time to bone lesion progression in patients with spine metastases from renal cell carcinoma.


KEY WORDS: Carcinoma, renal cell - Spine - Neoplasm metastasis - Surgery

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Publication History

Issue published online: February 28, 2017
Article first published online: October 21, 2016
Manuscript accepted: October 13, 2016
Manuscript revised: October 11, 2016
Manuscript received: September 13, 2016

Per citare questo articolo

Mosele GR, Caggiari G, Scarpa RM, Doria C. The treatment of vertebral metastases from renal cell carcinoma: a retrospective study. Minerva Urol Nefrol 2017;69:166-72. DOI: 10.23736/S0393-2249.16.02809-5

Corresponding author e-mail

moselegr@gmail.com