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Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy

Pembrolizumab has been used as a second-line systemic therapy for urothelial carcinoma. We herein report a case of cisplatin-resistant renal-pelvic urothelial carcinoma that was successfully resected after pembrolizumab treatment. A 74-year-old woman was referred to our hospital for further examinat...

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Autores principales: Kawahara, Takashi, Mochizuki, Taku, Sugimura, Rumiko, Izumi, Koji, Kuroda, Shinnosuke, Miyoshi, Yasuhide, Nakaigawa, Noboru, Yao, Masahiro, Tanabe, Mikiko, Uemura, Hiroji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696768/
https://www.ncbi.nlm.nih.gov/pubmed/31427950
http://dx.doi.org/10.1159/000501715
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author Kawahara, Takashi
Mochizuki, Taku
Sugimura, Rumiko
Izumi, Koji
Kuroda, Shinnosuke
Miyoshi, Yasuhide
Nakaigawa, Noboru
Yao, Masahiro
Tanabe, Mikiko
Uemura, Hiroji
author_facet Kawahara, Takashi
Mochizuki, Taku
Sugimura, Rumiko
Izumi, Koji
Kuroda, Shinnosuke
Miyoshi, Yasuhide
Nakaigawa, Noboru
Yao, Masahiro
Tanabe, Mikiko
Uemura, Hiroji
author_sort Kawahara, Takashi
collection PubMed
description Pembrolizumab has been used as a second-line systemic therapy for urothelial carcinoma. We herein report a case of cisplatin-resistant renal-pelvic urothelial carcinoma that was successfully resected after pembrolizumab treatment. A 74-year-old woman was referred to our hospital for further examination for gross hematuria and a renal-pelvis tumor. Retrograde pyelography showed a defect lesion in her renal pelvis and urinary cytology of the renal pelvis showed class V. Because staging CT could not deny lung metastasis, we planned to perform nephro-ureterectomy after evaluating the response to neoadjuvant chemotherapy. After three courses of gemcitabine and cisplatin chemotherapy, the original site showed progression; thus, nephro-ureterectomy was cancelled. We introduced pembrolizumab as a second-line therapy. After four courses of pembrolizumab treatment, the size of the original lesion was significantly decreased. During these therapies the lung tumor size was unchanged; thus, we determined that the lung tumor was not metastatic and performed nephro-ureterectomy. A pathological examination demonstrated that the tumor was completely resected with a negative surgical margin. We described the first case in which cisplatin-resistant renal pelvic tumor was successfully resected after pembrolizumab treatment.
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spelling pubmed-66967682019-08-19 Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy Kawahara, Takashi Mochizuki, Taku Sugimura, Rumiko Izumi, Koji Kuroda, Shinnosuke Miyoshi, Yasuhide Nakaigawa, Noboru Yao, Masahiro Tanabe, Mikiko Uemura, Hiroji Case Rep Oncol Case Report Pembrolizumab has been used as a second-line systemic therapy for urothelial carcinoma. We herein report a case of cisplatin-resistant renal-pelvic urothelial carcinoma that was successfully resected after pembrolizumab treatment. A 74-year-old woman was referred to our hospital for further examination for gross hematuria and a renal-pelvis tumor. Retrograde pyelography showed a defect lesion in her renal pelvis and urinary cytology of the renal pelvis showed class V. Because staging CT could not deny lung metastasis, we planned to perform nephro-ureterectomy after evaluating the response to neoadjuvant chemotherapy. After three courses of gemcitabine and cisplatin chemotherapy, the original site showed progression; thus, nephro-ureterectomy was cancelled. We introduced pembrolizumab as a second-line therapy. After four courses of pembrolizumab treatment, the size of the original lesion was significantly decreased. During these therapies the lung tumor size was unchanged; thus, we determined that the lung tumor was not metastatic and performed nephro-ureterectomy. A pathological examination demonstrated that the tumor was completely resected with a negative surgical margin. We described the first case in which cisplatin-resistant renal pelvic tumor was successfully resected after pembrolizumab treatment. S. Karger AG 2019-07-16 /pmc/articles/PMC6696768/ /pubmed/31427950 http://dx.doi.org/10.1159/000501715 Text en Copyright © 2019 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Kawahara, Takashi
Mochizuki, Taku
Sugimura, Rumiko
Izumi, Koji
Kuroda, Shinnosuke
Miyoshi, Yasuhide
Nakaigawa, Noboru
Yao, Masahiro
Tanabe, Mikiko
Uemura, Hiroji
Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy
title Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy
title_full Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy
title_fullStr Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy
title_full_unstemmed Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy
title_short Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy
title_sort successful resection of cisplatin-resistant renal pelvic cancer after the administration of pembrolizumab as second-line therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696768/
https://www.ncbi.nlm.nih.gov/pubmed/31427950
http://dx.doi.org/10.1159/000501715
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