TY - JOUR
T1 - Concomitant Renal Cell Carcinoma and Hematologic Malignan cyin Immunosuppressed Patients
AU - Johnson, Lewis
AU - Bylund, Jason
AU - Strup, Stephen
AU - Howard, Dianne
AU - Gul, Zartash
AU - Khan, Muhammad Waqas
AU - Venkatesh, Ramakrishna
N1 - Publisher Copyright:
© 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Objectives: Treatment of a renal mass in patients with hematologic malignancy or on immunosuppression can be complex and is not well defined. Surgical excision or thermal ablation of renal mass is generally recommended in view of concern for tumor progression in immunosuppressed patients. We report our management decision experience in patients and literature review on concomitant renal and hematologic malignancy. Materials and Methods: A retrospective medical record review of patients with renal cell carcinoma (RCC) and a hematologic malignancy over 3 years at our University Hospital was performed. Data were collected including patient's demographics, renal tumor and hematologic malignancy characteristics (stage, pathologic subtype, time of diagnosis, treatment type and prognosis). Surgical and medical management of each malignancy was reviewed and perioperative and overall outcomes are reported. Results: In total, 6 patients were identified with RCC and a hematologic malignancy of which 4 were on immunosuppressive therapy. A total of 5 patients had leukemia and 1 patient had multiple myeloma. Most kidney tumors were stage I, 83%; and 80% were Fuhrman grade II. There was equal distribution of clear cell and papillary-type RCC. All but 1 patient had undergone nephron-sparing surgery. Overall, 50% of our patients died within 1 year after renal surgery for pT1 a tumors from causes that are unrelated to renal cancer. Conclusions: Our small cohort showed significant mortality in patients with hematologic malignancy on immunosuppression, who had their renal mass treated with surgical excision or thermal ablation. However, this mortality was not secondary to surgical procedure itself. The prognosis of the hematologic malignancy might dictate the management of RCC.
AB - Objectives: Treatment of a renal mass in patients with hematologic malignancy or on immunosuppression can be complex and is not well defined. Surgical excision or thermal ablation of renal mass is generally recommended in view of concern for tumor progression in immunosuppressed patients. We report our management decision experience in patients and literature review on concomitant renal and hematologic malignancy. Materials and Methods: A retrospective medical record review of patients with renal cell carcinoma (RCC) and a hematologic malignancy over 3 years at our University Hospital was performed. Data were collected including patient's demographics, renal tumor and hematologic malignancy characteristics (stage, pathologic subtype, time of diagnosis, treatment type and prognosis). Surgical and medical management of each malignancy was reviewed and perioperative and overall outcomes are reported. Results: In total, 6 patients were identified with RCC and a hematologic malignancy of which 4 were on immunosuppressive therapy. A total of 5 patients had leukemia and 1 patient had multiple myeloma. Most kidney tumors were stage I, 83%; and 80% were Fuhrman grade II. There was equal distribution of clear cell and papillary-type RCC. All but 1 patient had undergone nephron-sparing surgery. Overall, 50% of our patients died within 1 year after renal surgery for pT1 a tumors from causes that are unrelated to renal cancer. Conclusions: Our small cohort showed significant mortality in patients with hematologic malignancy on immunosuppression, who had their renal mass treated with surgical excision or thermal ablation. However, this mortality was not secondary to surgical procedure itself. The prognosis of the hematologic malignancy might dictate the management of RCC.
KW - Concomitant malignancies
KW - Leukemia
KW - Renal cell carcinoma
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U2 - 10.1016/j.amjms.2016.02.027
DO - 10.1016/j.amjms.2016.02.027
M3 - Article
C2 - 27140706
AN - SCOPUS:84971014315
SN - 0002-9629
VL - 351
SP - 480
EP - 484
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 5
ER -