Title : The role of the orthopedist in the complex treatment of metastatic renal cell carcinoma
Abstract:
20-30% of the newly diagnosed cases of Renal Cell Carcinoma (RCC) have distant metastasis. Bones are one of the most frequent localizations of the RCC metastases. Nowadays the patients with the RCC metastases to the bones have a higher Overall Survival (OS) than those with the other (non-bone) localizations of distant metastases (40 vs. 20 months; p <0.001). This is an important and complex task to treat the patients successfully and to improve their quality of life. It requires a multidisciplinary approach.
In the 2022 the 49 y.o. patient, we`d like to present, was diagnosed cancer of the solitary right kidney IV grade, ?1bN0?1 [OSS, PANC]. Osteolytic metastases were found in the posterior segment of the 7th left rib, the distal metaepiphysis of the left radius. Partial nephrectomy (6 tumor nodes) with the intraoperative ultrasound with the paracaval lymph node dissection was performed. Then he received systemic antitumor therapy at his place of residence, and in the 2023 we performed the resection of the distal metaepiphysis of the radius of the left forearm and endoprosthetics with an individual 3D prosthesis on him. The postoperative period was uneventful. The patient was discharged on the 7th day after the operation in a satisfactory condition.
The antitumor systemic therapy has been continued after the operation. By now the data on progression has not been obtained, and significant reduction of the metastases in the pancreas has been verified. The patient notes satisfactory functional characteristics of the operated upper limb.
