Download from app store
We have detected that you are using an Ad Blocker.
PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker.
We have sent a message to the email address you have provided, . If this email is not correct, please update your settings with your correct address.
The email address you provided during registration, , does not appear to be valid. Please update your settings with a valid address before to continue using PracticeUpdate.
Please provide your AHPRA Number to ensure that you are given the correct level of access to our site.

In an effort to better serve our users, we have streamlined our content offering. As a result, we no longer publish new content or update existing content in Renal Cell Carcinoma. Visit the 'Content & Subscriptions' tab of your Settings page at any time to update your Dashboard or Newsletter Subscription preferences to continue to see news and information that interests you most.

featured
Published in Renal Cell Carcinoma

Expert Opinion / Cases · September 10, 2018

Resection of a Recurrent Clear Cell Lesion

 JoAnn Hsu
Written by

 

Discuss This item Follow

No comments yet, be the first to start the discussion!

  • Jozef Marenčák

    Sep 12, 2018

    According to my opinion, it is a metastasis and it is necessary to try to remove it (if the general condition of the patient allows it) - to resect and to apply chemotherapy according to the histological examination. The patient is only 67 years old.
    Jozef Marenčák, Assoc. Prof. , MD. , PhD.

  • Mario Alvarez Maestro

    Sep 14, 2018

    Without any doubt I recommend to remove this lesion

  • KC Safi

    Sep 15, 2018

    Giving multiple   recurrences at this stage I would do PET CT, if no other disease recurrences evident , then metastatectomy will be considered if they patient status permits another surgery, otherwise consider systemic TKIs therapy
    Khalid C.Safi,FRCS(Urol).
    
    t

  • Paulo Caldas

    Sep 18, 2018

    I agree with the possibility in offering metastasectomy, mainly if it’s in the same site where they had a positive margin.
    But the patient is 81 yo. It’s a very small lesion, slow growth and probably difficult to be found. I think could be observed as well.
    Don’t know about thermal ablation as an off label indication.

  • Huan Wang

    Sep 22, 2018

    In my opinion, maybe it is more reasonable to perform a biopsy of the lesion in the quadratus lumborum as the first step for the treatment of the patient, we can not ensure the lesion will be removed completely by an open re-operation, I believe the re-recurring risk of the disease will be high after re-operation(a study demonstrated that a big size renal cell carcinoma contained more aggressive histologic component. Alike, a repeated recurrent lesion probably indicates a more aggressive bio-behavior of the disease). The second step should be to recommend a genetic testing for the primary and/or secondary lesion. We should not forget that clear cell carcinoma has a good response to TKI-target therapy, more, almost 20% non-clear cell carcinoma has germline mutation which is potential guide for target treatment. Recently, there was a clinical trial showed that TKI-target therapy (sunitinib) alone was not inferior to cytoreductive nephrectomy followed by sunitinib in patients with metastatic RCC.

  • Nov 22, 2024

    Pending Moderator approval.
    Delete

Further Reading