International Urology and Nephrology

, Volume 23, Issue 1, pp 13–25 | Cite as

Metastatic renal cell carcinoma (RCC): Spontaneous regression, long-term survival and late recurrence

  • W. de Riese
  • K. Goldenberg
  • E. Allhoff
  • C. Stief
  • R. Schlick
  • S. Liedke
  • U. Jonas
Article

Abstract

We report 4 cases of metastatic renal cell carcinoma (RCC) with long-term survival either following radical nephrectomy alone or in combination with radioor hormonal therapy.

Two patients with lymph node metastases showed a long-term survival of 12 or more years following radical tumour nephrectomy (with lymphadenectomy) and radiotherapy. One of them exhibited a histologically proven tumour recurrence nearly 12 years after primary surgical treatment and died shortly later; the other one is still without any evidence of metastatic disease.

Two other patients exhibited spontaneous regression of pulmonary metastases: one regression occurred after radical tumour nephrectomy alone, the other one after successful primary hormonal treatment and subsequent radical tumour nephrectomy.

The following important aspects are emphasized:
  1. 1.

    Renal cell carcinoma is a very unpredictable tumour. Once the diagnosis of renal cell carcinoma is proved, a patient can never be considered cured.

     
  2. 2.

    Although adjuvant palliative nephrectomy has produced contradictory results in several reports, radical tumour nephrectomy either alone or in combination with other adjuvant therapies such as radiotherapy, hormonal or immunological treatment, can be worthwhile. Cases with long-term survival and spontaneous regression of distant metastases are proof of this. Besides, if carefully selected, the mortality rate of different adjuvant therapies is not significantly higher in patients with metastatic disease than in patients without metastases.

     

The world literature on this subject is reviewed.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bloom, H. J. G., Payne, P. M.: Hormone treatment of renal tumours: experimental and clinical observations. In: Riches, E. (ed.): Tumours of the Kidney and Ureter. E & S. Livingstone Ltd., Edinburgh 1964, p. 311.Google Scholar
  2. 2.
    Bloom, H. J. G.: Proceedings: hormone-induced and spontaneous regression of metastatic renal cancer.Cancer, 32, 1066 (1973).PubMedCrossRefGoogle Scholar
  3. 3.
    Bloom, H. J. G.: Adjuvant therapy for adenocarcinoma of the kidney: present position and prospects.Br. J. Urol., 45, 237 (1973).PubMedCrossRefGoogle Scholar
  4. 4.
    Bono, A. V., Benvenuti, C., Gianneo, E., Coneri, G. C., Roggia, A.: Progestogens in renal cell carcinoma. A retrospective study.Eur. Urol., 5, 94 (1979).PubMedGoogle Scholar
  5. 5.
    Bumpus, H. C. Jr.: The apparent disappearance of pulmonary metastases in a case of hypernephroma following nephrectomy.J. Urol., 20, 185 (1928).Google Scholar
  6. 6.
    De Kernion, J. B., Ramming, K. P., Smith, R. B.: The natural history of metastatic renal cell carcinoma: a computer analysis.J. Urol., 120, 148 (1978).Google Scholar
  7. 7.
    De Kernion, J. B.: Treatment of advanced renal cell carcinoma—traditional methods and innovative approaches.J. Urol., 130, 2 (1983).Google Scholar
  8. 8.
    De Riese, W., Goldenberg, K., Allhoff, E., Jonas, U.: Two cases of spontaneous regression of metastatic renal cell carcinoma (RCC) with long-term survival.Br. J. Urol. (in press).Google Scholar
  9. 9.
    Donaldson, J. C., Slease, R. B., Du Four, O. R., Saltzman, A. R.: Metastatic renal cell carcinoma 24 years after nephrectomy.JAMA, 236 8, 951 (1976).CrossRefGoogle Scholar
  10. 10.
    Everson, T. C., Cole, W. H.: Spontaneous Regression of Cancer. W. B. Saunders, Philadelphia 1966, 1187 pp.Google Scholar
  11. 11.
    Fairlamb, D. J.: Spontaneous regression of metastases of renal cancer: A report of two cases including the first recorded regression following irradiation of a dominant metastasis and review of the world literature.Cancer, 47, 2102 (1981).PubMedCrossRefGoogle Scholar
  12. 12.
    Freed, S. Z., Halperin, J. P., Gordon, M.: Idiopathic regression of metastases from renal cell carcinoma.J. Urol., 118, 538 (1977).PubMedGoogle Scholar
  13. 13.
    Garfield, D. H., Kennedy, B. J.: Regression of metastatic renal cell carcinoma following nephrectomy.Cancer, 30, 190 (1972).PubMedCrossRefGoogle Scholar
  14. 14.
    Hultquist, G. T.: Über Spontanheilung bei Hypernephromen.Beitr. Z. Path. Anat., 109, 29 (1947).Google Scholar
  15. 15.
    Johnson, D. E., Kaesler, K. E., Samuels, M. L.: Is nephrectomy justified in patients with metastatic renal carcinoma?J. Urol., 114, 27 (1975).PubMedGoogle Scholar
  16. 16.
    Katz, S. E., Schapira, H. E.: Spontaneous regression of genitourinary cancer—an update.J. Urol., 128, 1 (1982).PubMedGoogle Scholar
  17. 17.
    Kavoussi, L. R., Levine, S. R., Kadmon, D., Fair, W. R.: Regression of metastatic renal cell carcinoma: A case report and literature review.J. Urol., 135, 1005 (1986).PubMedGoogle Scholar
  18. 18.
    Klugo, R. C., Detmers, M., Stiles, R. E., Talley, R. W., Cerny, J. C.: Aggressive versus conservative management of Stage IV renal cell carcinoma.J. Urol., 118, 244 (1977).PubMedGoogle Scholar
  19. 19.
    McNichols, D. W., Segura, J. W., De Weerd, J. H.: Renal cell carcinoma: long-term survival and late recurrence.J. Urol., 126, 17 (1981).PubMedGoogle Scholar
  20. 20.
    Middleton, R. G.: Surgery for metastatic renal carcinoma.J. Urol., 97, 973 (1967).PubMedGoogle Scholar
  21. 21.
    Mims, M. M., Christenson, B., Schlumberger, F. C., Goodwin, W. E.: A ten-year evaluation of nephrectomy for extensive renal cell carcinoma.J. Urol., 95, 10 (1966).PubMedGoogle Scholar
  22. 22.
    Montie, J. E., Stewart, B. H., Straffon, R. A., Banowsky, L. H. W., Hevroitt, C. G., Montague, O. K.: The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma.J. Urol., 117, 272 (1977).PubMedGoogle Scholar
  23. 23.
    Rohdenburg, G. L.: Fluctuations in the growth energy of malignant tumours in man, with special reference to spontaneous regression.J. Cancer Res., 3, 193 (1918).Google Scholar
  24. 24.
    Satake, I., Tari, K., Yamamoto, M., Nishimura, H.: Neocarzinostatin-induced complete regression of metastatic renal cell carcinoma.J. Urol., 133, 87 (1985).PubMedGoogle Scholar
  25. 25.
    Skinner, D. G., Colvin, R. B., Vermillion, C. D., Pfister, R. C., Leadbetter, W. F.: Diagnosis and management of renal cell carcinoma.Cancer, 28, 1165 (1971).PubMedCrossRefGoogle Scholar
  26. 26.
    Snow, R. M., Schellhammer, P. F.: Spontaneous regression of metastatic renal cell carcinoma.Urology, XX, 2, 177 (1982).CrossRefGoogle Scholar
  27. 27.
    Stephenson, H. E. Jr., Delmez, J. A., Renden, D. J., Kimpton, R. S., Todd, P. C., Charron, T. L., Lindberg, O. A. B.: Host immunity and spontaneous regression of cancer evaluated by computerized data reduction study.Surg. Gynecol. Obstet., 133, 649 (1971).PubMedGoogle Scholar
  28. 28.
    Takatera, H., Maeda, O., Oka, T., Namiki, M., Nakano, E., Matsuda, M., Arita, N., Jamshidi, J., Ushio, Y., Sonoda, T.: Solitary late recurrence of renal cell carcinoma.J. Urol., 136, 799 (1986).PubMedGoogle Scholar
  29. 29.
    Wajsman, Z.: Editorial comment to: Satomi, Y., Takai, S., Kondo J., Fukushima, S., Furuhata, A.: Postoperative prophylactic use of progesterone in renal cell carcinoma.J. Urol., 128, 919 (1982).Google Scholar

Copyright information

© Akadémiai Kiadó 1991

Authors and Affiliations

  • W. de Riese
    • 1
  • K. Goldenberg
    • 1
  • E. Allhoff
    • 1
  • C. Stief
    • 1
  • R. Schlick
    • 1
  • S. Liedke
    • 1
  • U. Jonas
    • 1
  1. 1.Department of UrologyHannover Medical School (HMS)HannoverGermany

Personalised recommendations