뇌전이를 동반한 신세포암의 임상적 추적관찰
Clinical Follow-Up Study for Brain Metastases of Renal Cell Carcinoma
김성주, 김택상, 류현열,
소속 상세정보
김성주 ( Kim Seong-Ju )
고신대학교 복음병원 비뇨기과학교실
김택상 ( Kim Taek-Sang )
고신대학교 복음병원 비뇨기과학교실
류현열 ( Rhew Hyun-Yul )
고신대학교 복음병원 비뇨기과학교실
KMID : 0358320090500030224
Abstract
Purpose: We reviewed the records of renal cell carcinoma (RCC) patients with brain metastases, analyzed about survival and prognosis after several palliative management.
Materials and Methods: Between June 1998 and January 2008, 22 patients diagnosed to have brain metastases from RCC. We retrospectively reviewed their medical records, and analyzed clinical properties.
Results: Of 278 patients with RCC, 22 patients (7.9%) diagnosed to have brain metastases. The pathological T stages and Fuhrman nuclear grade of RCC at the time of initial diagnosis were various (T1: 1 patient, T2: 5, T3: 8, T4: 3, Fuhrman grade 1: 0, 2: 4, 3: 10, 4: 6, unknown: 2). Most of RCC was clear cell carcinoma (17/22). Most symptoms suggesting brain metastases were neurologic. Median cancer specific survival (CSS) of WBRT, radiosurgery, or surgery group (13/22) was 4 months, conservative management group (9/22) was 1.5 months and CSS of the former group
was significantly better. Median duration of development of brain metastasis after diagnosis of RCC was 28 month (1-120). There was no difference in CSS between patients with brain metastasis developed before and after 28 month (p=0.361).
Conclusions: Brain metastases of RCC have poor prognostic course. Development interval of brain metastases did not affect survival. WBRT, radiosurgery or surgery group showed better survival. Active intervention may improve survival.
키워드
Renal cell carcinoma;Metastases; Survival
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