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Published in Renal Cell Carcinoma and
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Expert Opinion / Cases · April 07, 2015

RCC Presenting With Spinal Metastasis

Written by
Heather R Greene MSN, FNP, AOCNP

 

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Heather Greene MSN, FNP, AOCNP

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  • Bradley Somer MD

    Bradley G. Somer MD

    Apr 08, 2015

    What is the Heng criteria? What is MSKCC criteria? This will impact both on the optimal first line management and also on prognosis
  • Heather Greene MSN, FNP, AOCNP

    Heather R Greene MSN, FNP, AOCNP

    Apr 13, 2015

    Lab findings included Hct 39, plts 259, WBC 8.4, calcium 9.7 and LDH was only slightly elevated. For the past several days he has had a hard time raising his left arm. He is requiring some assistance with day to day functionality because of this and KPS is approximately 60%.
    

    Heng: unfavorable risk group, score of 3, one point each for KPS <80%, time from diagnosis to treatment <1 year and anemia.
    

    MSKCC: poor risk group, score 3, one point each for KPS <80%, absence of nephrectomy and anemia.
    

    How would that impact your treatment decision for VEGF-TKI therapy?

  • Alexander Dudnichenko

    Apr 18, 2015

     The best management in this case will VEGF-TKI therapy plus bisphosphonates!

  • Andrew Fintel

    May 12, 2015

    The HENG and MSKCC for this patient would predict an overall survival of 7-8 months based on his unfavorable/poor risk group. There have been other prognostic risk criteria created more for the targeted therapy era, including the International Metastatic Renal Cell Carcinoma Database Consortium. Even with using these models, this patient is still a poor risk and has a poorer prognosis and likely would not respond well to targeted treatment, but given the patient's younger age and newer targeted therapies with a more favorable side effect profile, I would treat him.

  • Apr 19, 2024

    Pending Moderator approval.
    Delete

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