腎細胞癌骨転移の治療 - 外科治療を中心として -

Abstract

腎細胞癌骨転移15例の治療内容を検討した.外科切除は6例に施行し, 広範囲切除は2例に実施したが, 1例は6年4ヵ月CR生存, 1例は14年2ヵ月の長期生存を得た

Eighty-six patients with renal cell carcinoma underwent radical nephrectomy in Chiba Cancer Center Hospital. Fifteen of the 86 patients developed bone metastases. Seven of the 15 patients with bone metastases had received chemotherapy and radiotherapy. Six of the 15 patients underwent surgical treatment and two received radiotherapy alone. Of the six patients treated surgically for bone metastases, two patients were treated with wide resection and the remaining four patients underwent excision of the metastatic lesions in combination with radiotherapy, chemotherapy or immunotherapy. One of the two patients who underwent wide resection of a pelvic bone lesion is alive without evidence of disease for 6 years and 4 months. Another patient who underwent wide resection of femoral bone lesion survived for 14 years and 2 months but died of recurrent cancer. Pathologic findings of renal cell carcinoma in the long-time survivors showed adenocarcinoma of alveolar type of clear cell subtype and in grade 1. Wide resection of bone metastases of renal cell carcinoma can significantly prolong the survival time and improve the quality of life of the patients.