Modern approaches to treatment of tumors of the solitary kidney
https://doi.org/10.17650/1726-9776-2024-20-3-142-151
Abstract
Neoplasms of the solitary kidney account for <1–5 % of all tumors of the renal parenchyma. Nephron-sparing treatment is the treatment of choice in patients with a tumor of the solitary kidney. Oncological safety and maximum preservation of the kidney parenchyma are the main goals of nephron-sparing treatment. As part of a personalized approach, patients may be offered partial nephrectomy (open, robot-assisted, laparoscopic techniques), thermal ablation, stereotactic radiation therapy, and active surveillance.
Options for prescribing immuno-oncological drugs and tyrosine kinase inhibitors in the neoadjuvant setting followed by kidney resection are being studied. Sometimes nephron-sparing treatment is not possible and radical nephrectomy is required.
This review provides a comprehensive assessment of possible treatment options for solitary kidney tumors.
About the Authors
S. B. Petrov
I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia;
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
6–8 L’va Tolstogo St., Saint Petersburg 197022,
68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758
I. V. Zyatchin
I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
6–8 L’va Tolstogo St., Saint Petersburg 197022
S. A. Reva
I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia;
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
6–8 L’va Tolstogo St., Saint Petersburg 197022,
68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758
References
1. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan March 2023.
2. Campbell S.C., Clark P.E., Chang S.S. et al. Renal mass and localized renal cancer: evaluation, management, and follow-up: AUA Guideline: Part I. J Urol 2021;206(2):199–208. DOI: 10.1097/JU.0000000000001911
3. Saranchuk J.W., Touijer A.K., Hakimian P. et al. Partial nephrectomy for patients with a solitary kidney: the Memorial Sloan-Kettering experience. BJU Int 2004;94(9):1323–8. DOI: 10.1111/j.1464-410X.2004.05165.x
4. Ghavamian R., Cheville J.C., Lohse C.M. et al. Renal cell carcinoma in the solitary kidney: an analysis of complications and outcome after nephron sparing surgery. J Urol 2002;168(2):454–9. DOI: 10.1016/s0022-5347(05)64657-5
5. Fergany A.F., Saad I.R., Woo L., Novick A.C. Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases. J Urol 2006;175(5):1630–3; discussion 1633. DOI: 10.1016/S0022-5347(05)00991-2
6. La Rochelle J., Shuch B., Riggs S. et al. Functional and oncological outcomes of partial nephrectomy of solitary kidneys. J Urol 2009;181(5):2037–42; discussion 2043. DOI: 10.1016/j.juro.2009.01.024
7. Mues A.C., Korets R., Graversen J.A. et al. Clinical, pathologic, and functional outcomes after nephron-sparing surgery in patients with a solitary kidney: a multicenter experience. J Endourol 2012;26(10):1361–6. DOI: 10.1089/end.2012.0114
8. Ching C.B., Lane B.R., Campbell S.C. et al. Five to 10-year followup of open partial nephrectomy in a solitary kidney. J Urol 2013;190(2):470–4. DOI: 10.1016/j.juro.2013.03.028
9. Matveev V.B., Volkova M.I., Alborov S.V. et al. Partial nephrectomy for patients with a solitary kidney. Onkourologiya = Cancer Urology 2017;13(2):27–35. (In Russ.). DOI: 10.17650/1726-9776-2017-13-2-27-35
10. Hillyer S.P., Bhayani S.B., Allaf M.E. et al. Robotic partial nephrectomy for solitary kidney: a multi-institutional analysis. Urology 2013;81(1):93–7. DOI: 10.1016/j.urology.2012.08.055
11. Panumatrassamee K., Autorino R., Laydner H. et al. Robotic versus laparoscopic partial nephrectomy for tumor in a solitary kidney: a single institution comparative analysis. Int J Urol 2013;20(5):484–91. DOI: 10.1111/j.1442-2042.2012.03205.x
12. Zargar H., Bhayani S., Allaf M.E. et al. Comparison of perioperative outcomes of robot-assisted partial nephrectomy and open partial nephrectomy in patients with a solitary kidney. J Endourol 2014;28(10):1224–30. DOI: 10.1089/end.2014.0297
13. Benichou Y., Audenet F., Bensalah K. et al. Partial nephrectomy in solitary kidneys: comparison between open surgery and roboticassisted laparoscopy on perioperative and functional outcomes (UroCCR-54 study). World J Urol 2023;41(2):315–24. DOI: 10.1007/s00345-022-04026-y
14. Beksac A.T., Okhawere K.E., Abou Zeinab M. et al. Robotic partial nephrectomy for management of renal mass in patients with a solitary kidney: can we expand the indication to T2 and T3 disease? Minerva Urol Nephrol 2022;74(2):203–8. DOI: 10.23736/S2724-6051.22.04671-7
15. Lane B.R., Novick A.C., Babineau D. et al. Comparison of laparoscopic and open partial nephrectomy for tumor in a solitary kidney. J Urol 2008;179(3):847–51; discussion 852. DOI: 10.1016/j.juro.2007.10.050
16. Lane B.R., Derweesh I.H., Kim H.L. et al. Presurgical sunitinib reduces tumor size and may facilitate partial nephrectomy in patients with renal cell carcinoma. Urol Oncol 2015;33(3):112.e15–21. DOI: 10.1016/j.urolonc.2014.11.009
17. Hellenthal N.J., Underwood W., Penetrante R. et al. Prospective clinical trial of preoperative sunitinib in patients with renal cell carcinoma. J Urol 2010;184(3):859–64. DOI: 10.1016/j.juro.2010.05.041
18. Silberstein J.L., Millard F., Mehrazin R. et al. Feasibility and efficacy of neoadjuvant sunitinib before nephron-sparing surgery. BJU Int 2010;106(9):1270–6. DOI: 10.1111/j.1464-410X.2010.09357.x
19. Gorin M.A., Ekwenna O., Soloway M.S., Ciancio G. Dramatic reduction in tumor burden with neoadjuvant sunitinib prior to bilateral nephron-sparing surgery. Urology 2012;79(2):e11. DOI: 10.1016/j.urology.2011.04.018
20. Tochigi K., Funahashi Y., Mori A. et al. Pre-surgical sunitinib treatment enabling nephron-sparing surgery in a patient with renal cell carcinoma in a solitary kidney. Nagoya J Med Sci 2019;81(2):337–40. DOI: 10.18999/nagjms.81.2.337
21. Powers M.K., Sartor O., Lee B.R. Neoadjuvant tyrosine kinase downstaging of T2 renal cell carcinoma in solitary kidney before robotic partial nephrectomy. J Endourol Case Rep 2015;1(1):47–9. DOI: 10.1089/cren.2015.0005
22. Rini B.I., Plimack E.R., Takagi T. et al. A phase II study of pazopanib in patients with localized renal cell carcinoma to optimize preservation of renal parenchyma. J Urol 2015;194(2):297–303. DOI: 10.1016/j.juro.2015.03.096
23. Hakimi K., Campbell S.C., Nguyen M.V. et al. PADRES: a phase 2 clinical trial of neoadjuvant axitinib for complex partial nephrectomy. BJU Int 2024;133(4):425–31. DOI: 10.1111/bju.16217
24. Weisbrod A.J., Atwell T.D., Frank I. et al. Percutaneous cryoablation of masses in a solitary kidney. AJR Am J Roentgenol 2010;194(6):1620–5. DOI: 10.2214/AJR.09.2978
25. Bhindi B., Mason R.J., Haddad M.M. et al. Outcomes after cryoablation versus partial nephrectomy for sporadic renal tumors in a solitary kidney: a propensity score analysis. Eur Urol 2018;73(2):254–9. DOI: 10.1016/j.eururo.2017.09.009
26. Haber G.P., Lee M.C., Crouzet S. et al. Tumour in solitary kidney: laparoscopic partial nephrectomy vs laparoscopic cryoablation. BJU Int 2012;109(1):118–24. DOI: 10.1111/j.1464-410X.2011.10287.x
27. Yasuda Y., Zhang J.H., Attawettayanon W. et al. Comprehensive management of renal masses in solitary kidneys. Eur Urol Oncol 2023;6(1):84–94. DOI: 10.1016/j.euo.2022.11.004
28. Siva S., Ali M., Correa R.J.M. et al. 5-year outcomes after stereotactic ablative body radiotherapy for primary renal cell carcinoma: an individual patient data meta-analysis from IROCK (the International Radiosurgery Consortium of the Kidney). Lancet Oncol 2022;23(12):1508–16. DOI: 10.1016/S14702045(22)00656-8
29. Correa R.J.M., Louie A.V., Staehler M. et al. Stereotactic radiotherapy as a treatment option for renal tumors in the solitary kidney: a multicenter analysis from the IROCK. J Urol 2019;201(6):1097–104. DOI: 10.1097/JU.0000000000000111
30. Pierorazio P.M., Johnson M.H., Ball M.W. et al. Five-year analysis of a multi-institutional prospective clinical trial of delayed intervention and surveillance for small renal masses: the DISSRM registry. Eur Urol 2015;68(3):408–15. DOI: 10.1016/j.eururo.2015.02.001
31. Roussel E., Laenen A., Bhindi B. et al. Predicting short- and longterm renal function following partial and radical nephrectomy. Urol Oncol 2023;41(2):110.e1–6. DOI: 10.1016/j.urolonc.2022.10.006
Review
For citations:
Petrov S.B., Zyatchin I.V., Reva S.A. Modern approaches to treatment of tumors of the solitary kidney. Cancer Urology. 2024;20(3):142-151. (In Russ.) https://doi.org/10.17650/1726-9776-2024-20-3-142-151
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