Медицинская и хирургическая урология

Медицинская и хирургическая урология
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ISSN: 2168-9857

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Cytoreductive Nephrectomy in Metastatic Kidney Cancer: Experience of the Urology Department at Aristide Le Dantec University Teaching Hospital

Boris Amougou1* , Yaya Sow2, Arlette Dongmo1, David Douglas Banga Nkomo1, Jean Paul Engbang3, Théodore Sala Beyeme3, Joseph Fondop1, Demba Cissé4, Faustin Atemkeng1, Boubacar Fall5, Babacar Diao6, Abdoulaye Bobo Diallo4, Alain Khassim Ndoye6, Fru Angwafor III7, Mamadou Ba6

Aim: to assess the place of cytoreductive nephrectomy in the management of metastatic kidney cancer in our daily practice.

Patients and methods: This was a retrospective, descriptive and analytical study from January 2010 to December 2014 on patients aged 18 years and over operated for metastatic kidney cancer. The variables studied were prognostic: Performance Status, tumor stage, sites and number of metastatic sites, prognosis group according to Heng's model, histological type and Furhman grade of the nephrectomy specimen, follow-up postoperative course and overall survival.

Results: A total of 12 patients were included. The mean size of the largest axis of the tumors was 14.06 ± 5.3 cm with extremes of 8.2 and 23.8 cm and the tumor was graded T3 in 6 cases. The majority of patients had a single metastatic site and the lung was the most common metastatic site in 9 cases. In half of the cases the ECOG-PS score was 1. In 6 cases the patients were classified in the Heng intermediate prognosis group. Lymph node dissection was associated with nephrectomy in 4 cases. Renal adenocarcinoma was the most common histologic type in 8 cases and Furhman's grade was only specified in 6 cases. The mean duration of follow-up was 10.1 ± 13.4 months (range 1 and 39 months), overall survival at 2 years was poor and only 2 patients were alive 3 years and 4 years after their nephrectomy.

Conclusion: Metastatic kidney cancer is uncommon in our context; most of our patients consult with advanced stage tumors. Systemic treatment remains difficult for our populations to access. Nephrectomy remains the main weapon at our disposal.

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