Cargando…
The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review
SIMPLE SUMMARY: Renal cell carcinoma is a highly metastatic tumor, mainly to the lungs (50%), bone (49%), lymph-nodes (6–32%), liver (8%), and brain (3%). A wide and accurate literature review has disclosed only 51 cases of intradural spinal metastasis from sporadic renal cell carcinoma, of which 32...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8945914/ https://www.ncbi.nlm.nih.gov/pubmed/35326745 http://dx.doi.org/10.3390/cancers14061595 |
_version_ | 1784674067754778624 |
---|---|
author | Corvino, Sergio Mariniello, Giuseppe Solari, Domenico Berardinelli, Jacopo Maiuri, Francesco |
author_facet | Corvino, Sergio Mariniello, Giuseppe Solari, Domenico Berardinelli, Jacopo Maiuri, Francesco |
author_sort | Corvino, Sergio |
collection | PubMed |
description | SIMPLE SUMMARY: Renal cell carcinoma is a highly metastatic tumor, mainly to the lungs (50%), bone (49%), lymph-nodes (6–32%), liver (8%), and brain (3%). A wide and accurate literature review has disclosed only 51 cases of intradural spinal metastasis from sporadic renal cell carcinoma, of which 32 at intramedullary and 19 at extramedullary localizations. Once detected, they represent a sign of advanced disease and often lead to rapidly progressive neurological deficits. Because of these few reported data, there are no defined guidelines of treatment and the decision making in the choice of the best strategy should consider the curative, functional and palliative aspects, accordingly the management should be tailored for each patient. The options include surgery, radiotherapy, and chemotherapy, which can be performed in isolation or various combinations at the discretion of each institution. We discuss the role of surgery in the management of spinal intradural metastases from renal cell carcinoma. ABSTRACT: Background: Due to the few reported cases of spinal intradural metastases from renal cell carcinoma (RCC), there is no unanimous consensus on the best treatment strategy, including the role of surgery. Methods: A wide and accurate literature review up to January 2022 has disclosed only 51 cases of spinal intradural metastases from RCC. Patients with extramedullary (19) and those with intramedullary (32) localization have been separately considered and compared. Demographics, clinical, pathological, management, and outcome features have been analyzed. Results: Extramedullary lesions more frequently showed the involvement of the lumbar spine, low back pain, and solitary metastasis at diagnosis. Conversely, the intramedullary lesions were most often detected in association with multiple localizations of disease, mainly in the brain. Surgery resulted in improvement of clinical symptoms in both groups. Conclusion: Several factors affect the prognosis of metastatic RCC. The surgical removal of spinal metastases resulted in pain relief and the arresting of neurological deficit progression, improving the quality of life and overall survival of the patient. Considering the relative radioresistant nature of the RCC, the surgical treatment of the metastasis is a valid option even if it is subtotal, with a consequent increased risk of recurrence, and/or a nerve root should be sacrificed. |
format | Online Article Text |
id | pubmed-8945914 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89459142022-03-25 The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review Corvino, Sergio Mariniello, Giuseppe Solari, Domenico Berardinelli, Jacopo Maiuri, Francesco Cancers (Basel) Review SIMPLE SUMMARY: Renal cell carcinoma is a highly metastatic tumor, mainly to the lungs (50%), bone (49%), lymph-nodes (6–32%), liver (8%), and brain (3%). A wide and accurate literature review has disclosed only 51 cases of intradural spinal metastasis from sporadic renal cell carcinoma, of which 32 at intramedullary and 19 at extramedullary localizations. Once detected, they represent a sign of advanced disease and often lead to rapidly progressive neurological deficits. Because of these few reported data, there are no defined guidelines of treatment and the decision making in the choice of the best strategy should consider the curative, functional and palliative aspects, accordingly the management should be tailored for each patient. The options include surgery, radiotherapy, and chemotherapy, which can be performed in isolation or various combinations at the discretion of each institution. We discuss the role of surgery in the management of spinal intradural metastases from renal cell carcinoma. ABSTRACT: Background: Due to the few reported cases of spinal intradural metastases from renal cell carcinoma (RCC), there is no unanimous consensus on the best treatment strategy, including the role of surgery. Methods: A wide and accurate literature review up to January 2022 has disclosed only 51 cases of spinal intradural metastases from RCC. Patients with extramedullary (19) and those with intramedullary (32) localization have been separately considered and compared. Demographics, clinical, pathological, management, and outcome features have been analyzed. Results: Extramedullary lesions more frequently showed the involvement of the lumbar spine, low back pain, and solitary metastasis at diagnosis. Conversely, the intramedullary lesions were most often detected in association with multiple localizations of disease, mainly in the brain. Surgery resulted in improvement of clinical symptoms in both groups. Conclusion: Several factors affect the prognosis of metastatic RCC. The surgical removal of spinal metastases resulted in pain relief and the arresting of neurological deficit progression, improving the quality of life and overall survival of the patient. Considering the relative radioresistant nature of the RCC, the surgical treatment of the metastasis is a valid option even if it is subtotal, with a consequent increased risk of recurrence, and/or a nerve root should be sacrificed. MDPI 2022-03-21 /pmc/articles/PMC8945914/ /pubmed/35326745 http://dx.doi.org/10.3390/cancers14061595 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Corvino, Sergio Mariniello, Giuseppe Solari, Domenico Berardinelli, Jacopo Maiuri, Francesco The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review |
title | The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review |
title_full | The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review |
title_fullStr | The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review |
title_full_unstemmed | The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review |
title_short | The Role of Surgery in Spinal Intradural Metastases from Renal Cell Carcinoma: A Literature Review |
title_sort | role of surgery in spinal intradural metastases from renal cell carcinoma: a literature review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8945914/ https://www.ncbi.nlm.nih.gov/pubmed/35326745 http://dx.doi.org/10.3390/cancers14061595 |
work_keys_str_mv | AT corvinosergio theroleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT mariniellogiuseppe theroleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT solaridomenico theroleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT berardinellijacopo theroleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT maiurifrancesco theroleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT corvinosergio roleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT mariniellogiuseppe roleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT solaridomenico roleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT berardinellijacopo roleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview AT maiurifrancesco roleofsurgeryinspinalintraduralmetastasesfromrenalcellcarcinomaaliteraturereview |