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Renal Cell Carcinoma
Center of Excellence
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Jozef Marenčák
Sep 12, 2018
According to my opinion, it is a metastasis and it is necessary to try to remove it (if the general condition of the patient allows it) - to resect and to apply chemotherapy according to the histological examination. The patient is only 67 years old.
Jozef Marenčák, Assoc. Prof. , MD. , PhD.
Mario Alvarez Maestro
Sep 14, 2018
Without any doubt I recommend to remove this lesion
KC Safi
Sep 15, 2018
Giving multiple recurrences at this stage I would do PET CT, if no other disease recurrences evident , then metastatectomy will be considered if they patient status permits another surgery, otherwise consider systemic TKIs therapy
Khalid C.Safi,FRCS(Urol).
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Paulo Caldas
Sep 18, 2018
I agree with the possibility in offering metastasectomy, mainly if it’s in the same site where they had a positive margin.
But the patient is 81 yo. It’s a very small lesion, slow growth and probably difficult to be found. I think could be observed as well.
Don’t know about thermal ablation as an off label indication.
Huan Wang
Sep 22, 2018
In my opinion, maybe it is more reasonable to perform a biopsy of the lesion in the quadratus lumborum as the first step for the treatment of the patient, we can not ensure the lesion will be removed completely by an open re-operation, I believe the re-recurring risk of the disease will be high after re-operation(a study demonstrated that a big size renal cell carcinoma contained more aggressive histologic component. Alike, a repeated recurrent lesion probably indicates a more aggressive bio-behavior of the disease). The second step should be to recommend a genetic testing for the primary and/or secondary lesion. We should not forget that clear cell carcinoma has a good response to TKI-target therapy, more, almost 20% non-clear cell carcinoma has germline mutation which is potential guide for target treatment. Recently, there was a clinical trial showed that TKI-target therapy (sunitinib) alone was not inferior to cytoreductive nephrectomy followed by sunitinib in patients with metastatic RCC.
Apr 25, 2024
Pending Moderator approval.
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JoAnn
Hsu
Jozef Marenčák
Sep 12, 2018
Mario Alvarez Maestro
Sep 14, 2018
KC Safi
Sep 15, 2018
Paulo Caldas
Sep 18, 2018
Huan Wang
Sep 22, 2018
Apr 25, 2024
Pending Moderator approval.