Surgical resection of brain metastases from renal cell carcinoma in 50 patients

doi:10.1016/S0090-4295(99)80413-0

Urology

Volume 47, Issue 2, February 1996, Pages 187-193

https://doi.org/10.1016/S0090-4295(99)80413-0 Get rights and content

Abstract

Objectives

Metastases are frequently diagnosed among patients with renal cell carcinoma (RCC). Of 709 patients with brain metastases (BMET) who were operated on at our institution between 1974 and 1993, 50 (7%) were of renal origin.

Methods

Medical records were reviewed retrospectively. Survival time was calculated by the Kaplan-Meier method and Cox proportional hazards model.

Results

There were 38 men and 12 women. The median age was 60 years. The primary RCC was resected in 47 patients. Forty patients had a metachronous diagnosis of RCC and BMET. Median interval between the diagnosis of RCC and BMET was 17 months. In all 50 patients overall median survival (MS) from diagnosis of primary RCC was 31.4 months and from craniotomy was 12.6 months. Postoperative mortality was 10% (5 patients). In patients with primary RCC in the left kidney (n = 25) versus right kidney (n = 25) median survival from craniotomy was longer: 21.3 versus 7.4 months (P < 0.014). Twenty-three patients (46%) had intratumoral hemorrhage. Eight patients had cerebellar metastasis (MS, 3.0 months) and 9 had multiple metastases resected (MS, 7.6 months). Thirty-eight patients had both brain and pulmonary metastases, and 16 of them had pulmonary resection (MS, 18.6 versus 8.0 months; P <0.03). Twenty-two patients received whole brain radiation therapy (WBRT) after craniotomy and 18 did not receive WBRT (MS, 13.3 versus 14.5 months; P 0.62). The 1-year, 2-year, 3-year, and 5-year survival was 51%, 24%, 22%, and 8.5%, respectively.

Conclusions

Only the resection of lung metastasis, supratentorial location of BMET, left-sided localization of primary RCC, and lack of neurologic deficit before craniotomy were statistically significant prognostic factors in Cox regression analysis. In the absence of effective systemic treatment, we suggest that patients with BMET from RCC be considered for operative resection for treatment and palliation.

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Surgical resection of brain metastases from renal cell carcinoma in 50 patients

Abstract

Objectives

Methods

Results

Conclusions

J Urol

J Urol

J Urol

Urology

Int J Radiat Oncol Biol Phys

Cancer

J Surg Oncol

J Urol

Urol Clin North Am

Neurol Neurochir Pol

Neuroradiology

Ann Thorac Surg

J Neurosurg

Clinical manifestations and treatment of renal parenchymal tumors

Tumors of the genitourinary tract

Prognostic factors in metastatic renal cell carcinoma

Metastatic hypernephroma of the brain from a neurosurgical point of view. A report of 19 cases

J Neurosurg

Single brain metastases from kidney tumors. Clinico-pathologic considerations on a series of 29 cases

Tumori

Non-parametric estimation from incomplete observations

J Am Stat Assoc

Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and ex-amples

Br J Cancer

Regression models and life tables

J R Stat Soc

On hypernephroma in central nervous system (in German)

Arch Psychiatr Nervenkr 63:

On brain metastases from hypernephroma (in German)

Arch Psychiatr Nervenkr