Introduction: Pelvic bone metastases from renal cell carcinoma (RCC) are challenging due to their destructive pattern, poor response to radiotherapy and hypervascularity. The purpose of our study was to review a series of patients undergoing surgical treatment with the aim to investigate: 1) survival; 2) local disease control; and 3) complications. Methods: A series of 16 patients was reviewed. A curettage procedure was performed on 12 patients. In eight the lesion involved the acetabulum; a cemented hip arthroplasty with cage was performed in seven; a flail hip in one. Four patients received a resection; in two cases with acetabular involvement, reconstruction was performed with a custom-made prosthesis and with an allograft and prosthesis. Results: Disease-specific survival accounted for 70% at 3 years and 41% at 5 years. Only one local tumor progression after curettage occurred. Revision surgery (flail hip) was necessary for deep infection of the custom-made prosthesis. Conclusion: A prolonged survival in patients affected by bone metastatic disease from RCC can justify also major surgical procedures. Due to a low local progression rate after intralesional procedures, curettage, cement and a total hip arthroplasty with cage, when feasible, should be considered as an alternative to more demanding surgeries like resections and reconstructions. Level of evidence (oxford): Level 4.

Surgical treatment for pelvic bone metastatic disease from renal cell carcinoma / Scoccianti, Guido; Scanferla, Roberto; Scorianz, Maurizio; Frenos, Filippo; Sacchetti, Federico; Muratori, Francesco; Campanacci, Domenico A. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - ELETTRONICO. - (2023), pp. 0-0. [10.1002/jso.27305]

Surgical treatment for pelvic bone metastatic disease from renal cell carcinoma

Scoccianti, Guido;Scanferla, Roberto;Scorianz, Maurizio;Frenos, Filippo;Sacchetti, Federico;Muratori, Francesco;Campanacci, Domenico A
2023

Abstract

Introduction: Pelvic bone metastases from renal cell carcinoma (RCC) are challenging due to their destructive pattern, poor response to radiotherapy and hypervascularity. The purpose of our study was to review a series of patients undergoing surgical treatment with the aim to investigate: 1) survival; 2) local disease control; and 3) complications. Methods: A series of 16 patients was reviewed. A curettage procedure was performed on 12 patients. In eight the lesion involved the acetabulum; a cemented hip arthroplasty with cage was performed in seven; a flail hip in one. Four patients received a resection; in two cases with acetabular involvement, reconstruction was performed with a custom-made prosthesis and with an allograft and prosthesis. Results: Disease-specific survival accounted for 70% at 3 years and 41% at 5 years. Only one local tumor progression after curettage occurred. Revision surgery (flail hip) was necessary for deep infection of the custom-made prosthesis. Conclusion: A prolonged survival in patients affected by bone metastatic disease from RCC can justify also major surgical procedures. Due to a low local progression rate after intralesional procedures, curettage, cement and a total hip arthroplasty with cage, when feasible, should be considered as an alternative to more demanding surgeries like resections and reconstructions. Level of evidence (oxford): Level 4.
2023
0
0
Scoccianti, Guido; Scanferla, Roberto; Scorianz, Maurizio; Frenos, Filippo; Sacchetti, Federico; Muratori, Francesco; Campanacci, Domenico A
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1310219
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