Summary
Twenty-five patients with primary metastatic adenocarcinoma renis were treated by embolization and delayed nephrectomy. The objective of the study was to examine whether the natural history of the disease is influenced by this combined treatment. Most patients (19/25) had measurable metastatic lesions. No patient received additional therapy unless progression occurred. Embolization was mainly performed with Gelfoam and Gianturco coils. Complete remission of metastases was observed in 1 patient (still in remission after 36 months); stable disease in 6 patients (lasting between 14 and 31 months). Eighteen patients died after a median survival of 5.7 months (range 14 days to 11 months). No major complication related to the embolization procedure occurred. Angio-infarction followed by nephrectomy cannot be recommended for widespread use in patients with primary metastatic kidney carcinoma. The procedure may be tested in controlled clinical trials together with other treatment protocols, such as immunotherapy, infarction with radioactive particles, or chemoembolization. These approaches are experimental and therefore limited to institutions with sufficient experience.
Similar content being viewed by others
References
Abbou CC, Lagrue S, Chopin D, Auvert J, Benameur Ch, Larde D (1980) Embolisation artérielle et traitement des cancers du rein. Ann Urol 14:272–275
Almgard LE, Fernström I, Haverling M, Ljungqvist A (1973) Treatment of renal adenocarcinoma by embolic occlusion of the renal circulation. Br J Urol 45:474–479
Altaffer LF, Chenault OW (1979) Paraneoplastic endocrinopathies associated with renal tumors. J Urol 122:573–577
Bakke A, Göthlin JH, Haukaas SA, Kalland T (1982) Augmentation of natural killer cell activity after arterial embolization of renal carcinomas. Cancer Res 42:3880–3883
Belis JA, Horton JA (1982) Renal artery embolization with polyvinyl alcohol foam particles. Urology 19:224–227
Ben-Menachem Y, Crigler CM, Corriere JN (1975) Elective transcatheter renal artery occlusion prior to nephrectomy. J Urol 114:355–359
Bergreen PW, Woodside J, Paster S (1977) Therapeutic renal infarction. J Urol 118:372–374
Bloom HJG (1973) Hormone-induced and spontaneous regression of metastatic renal cancer. Cancer 32:1066–1071
Bracken RB, Johnson DE, Goldstein HM, Wallace S, Ayala AG (1975) Percutaneous transfemoral renal artery occlusion in patients with renal carcinoma. Urology 6:6–10
Bücheler E, Hupe W, Hertel EU, Klosterhalfen H (1976) Katheterembolisation von Nierentumoren. Fortschr Röntgenstr 124:134–138
Bush WH, Freeny PC, Correa RJ (1980) Transcatheter vascular occlusive therapy in genitourinary problems. Bull Mason Clin 34:1–9
Buzelin JM, Bourdon J, Mitard D, Buzelin F, Auvigne J (1974) L'embolisation de l'artère rénale. J Urol Nephrol 80:541–553
Carmigniani G, Belgrano E, Puppo P, Cornaglia P (1977) T- and B-lymphocyte levels in renal cancer patients: influence of peroperative transcatheter embolization and radical nephrectomy. J Urol 118:941–943
Chuang VP, Wallace S, Swanson DA (1981) Technique and complications of renal carcinoma infarction. Urol Radiol 2:223–228
DeWeerd JH, Hawthorne J, Adson MA (1977) Regression of renal cell hepatic metastasis following removal of primary lesions. J Urol 117:790–792
Dickson JA, Shah SA (1980) Hyperthermia and the immune response in cancer therapy. Cancer Immunol Immunother 9:1–10
Doolittle KH (1976) Spontaneous remission of solitary bone metastasis after removal of the primary kidney carcinoma. J Urol 116:803–804
Fairlamb DJ (1981) Spontaneous regression of metastases of renal cancer: a report of 2 cases following irradiation of a dominant metastasis and review of the world literature. Cancer 47:2102–2106
Freed SZ, Halperin JP, Gordon M (1977) Idiopathic regression of metastases from renal cell carcinoma. J Urol 118:538–542
Gang DL, Dole KB, Adelman LS (1977) Spinal cord infarction following therapeutic renal artery embolization. JAMA 237:2841–2842
Gottesman JE, Crawford ED, Grossman HB, Scardino P, McCracken JD (1983) Infarction — Nephrectomy for metastatic renal carcinoma. Southwest Oncology Group Study. 72th Annual Meeting of the American Urological Association, Las Vegas 1983 (abstr no 530)
Hrushesky WJ, Murphy GP (1977) Current status of the therapy of advanced renal carcinoma. J Surg Oncol 9:277–288
Johnson DE, Kaesler KE, Samuels ML (1975) Is nephrectomy justified in patients with metastatic renal carcinoma? J Urol 114:27–29
Kato T, Nemoto R, Mori H, Takahashi M, Tamakawa Y (1981) Transcatheter arterial chemoembolization of renal cell carcinoma with microencapsulated Mitomycin-C. J Urol 125:19–24
Katzenstein AL, Purvis R Jr, Gmelich J, Askin F (1978) Pulmonary resection for metastatic renal adenocarcinoma: pathologic findings and therapeutic value. Cancer 41:712–723
Klugo RC, Detmers M, Stiles RE, Talley RW, Cerny JC (1977) Aggressive versus conservative management of stage IV renal cell carcinoma. J Urol 118:244–246
Krane RJ (1983) Cancer immunotherapy. Urologist's Correspondence Club, letter 93, September
Lang EK, Sullivan J, DeKernion JB (1983) Work in progress: transcatheter embolization of renal cell carcinoma with radioactive infarct particles. Radiology 147:413–418
Linnenbank F (1980) Ruggemergbeschadiging door het röntgenologisch onderzoek van de aorta en haar zijtakken. Ned Tijdschr Geneeskd 124:1555–1558
Lokich JJ, Hartwell Harrison J (1975) Renal cell carcinoma: natural history and chemotherapeutic experience. J Urol 114:371–374
Marberger M, Georgi M (1975) Balloon occlusion of the renal artery in tumor nephrectomy. J Urol 114:360–363
Marx FJ, Chaussy Ch, Moser E (1982) Grenzen und Gefahren der palliativen Embolisation inoperabler Nierentumoren. Urologe 21:206–210
Middleton RG (1967) Surgery for metastatic renal cell carcinoma. J Urol 97:973–977
Montie JE, Stewart BH, Straffon RA, Banowsky LHW, Hewitt CB, Montague DK (1977) The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma. J Urol 117:272–275
Mukamel E, Hadar H, Nissenkorn I, Servadio C (1979) Widespread dissemination of Gelfoam particles complicating occlusion of renal circulation. Urology 14:194–197
Neidhart JA, Gagen M, Young D, Wise H (1983) A randomized study of polymerized tumor antigen admixed with adjuvant (PTA) for therapy of renal cancer. Proc ASCO, San Diego (abstr no C-189)
Pauer W, Mikuz G, Jakse G (1981) Ist die Nephrektomie beim metastasierenden Nierenkarzinom sinnvoll? Aktuel Urol 12:146–149
Pontonnier F, Plante P, Mourlan D, Vidal R (1980) Embolisation rénale dans le traitement des tumeurs du rein. Ann Urol 12:243–247
Richard F, Carvalho R, le Gall E, Chatelain C (1981) Résultats immédiats et lointains du traitement chirurgical der l'adénocarcinoma rénal. Ann Urol 15:361–365
Rosenkrantz H, Sands JP, Buchta KS, Healy JF, Kmet JP, Gerber F (1982) Renal devitalization using 95% ethyl alcohol. J Urol 127:873–875
Schulman CC, Struyen J, Giannakopoulos X, Mathieu J (1980) Preoperative embolization of renal tumors — Comparison of different methods. Eur Urol 6:154–157
Servadio C (1980) Chemotherapy of renal adenocarcinoma. UICC, Geneva (UICC technical report ser vol 49)
Skinner DG, deKernion JB (1978) Clinical manifestations and treatment of renal parenchymal tumors. In: Skinner DG, deKernion JB (eds) Genitourinary cancer. Saunders, Philadelphia London Toronto
Skinner DG, Vernillion CD, Colvin RB (1972) The surgical management of renal cell carcinoma. J. Urol 107:705–710
Stösslein F, Schöpke W, Porstmann W, Fleck H, Köhler H, Sachmeckel C, Steude U (1981) Die präoperative Nierenembolisierung maligner Tumoren bei externen Patienten. Z Urol Nephrol 74:721–728
Swanson DA, Wallace S, Johnson DE (1980) The role of embolization and nephrectomy in the management of metastatic renal carcinoma. Urol Clin North Am 7:719–730
Swanson DA, Johnson DE, von Eschenbach AC, Chuang VP, Wallace S (1983) Angioinfarction plus nephrectomy for metastatic renal cell carcinoma — Update. J Urol 130:449–452
Thelen M, Brühl P, Gerlach F, Biersack HJ (1976) Katheterembolisation von metastasierten Nierenkarzinomen mit Butyl-2-Cyanoacrylate. Fortschr Röntgenstr 124:232–235
Tolia BM, Whitmore WF (1975) Solitary metastasis from renal cell carcinoma. J Urol 114:836–838
Turner RD, Rand RW, Bentson JR, Mosso JA (1975) Ferromagnetic silicone necrosis of hypernephromas by selective vascular occlusion to the tumor: a new technique. J Urol 113:455–459
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kurth, K.H., Cinqualbre, J., Oliver, R.T.D. et al. Embolization and subsequent nephrectomy in metastatic renal cell carcinoma. World J Urol 2, 122–126 (1984). https://doi.org/10.1007/BF00328091
Issue Date:
DOI: https://doi.org/10.1007/BF00328091