Carcinoma of the Collecting Ducts of Bellini of the Kidney: Adjuvant Chemotherapy Followed by Multikinase Inhibition with Sunitinib

摘要

Background: Carcinoma of the collecting ducts (CDC) of Bellini o the kidney is very rare but is among the most aggressive urologic entities. Patients and Methods: Radical nephrectomy revealed CDC in stage pT3a pN2 MO G3 in 2 male patients. Four courses of ad juvant chemotherapy with cisplatin and gemcitabine were given Results: Subsequent restaging revealed local recurrence and lymph node metastases. Both patients were operated on again, and metastat ic CDC was found. Second-line therapy with sunitinib was administered After 2 cycles, multiple liver, lung, and bone metastases and mediasti nal lymphopathy occurred. Eight weeks later, the patients died, with a survival of 8 months from initial diagnosis. Conclusion: Nephrectomy adjuvant gemcitabine/cisplatin, and sunitinib therapy did not alter the course of disease in these patients. Gross resection of disease was rapidly followed by local recurrence and, subsequently, widespread dissemination of disease. Clinical trial investigation is urgently needed because of the aggressive and refractory nature of CDC.