Embolization of the Renal Artery in Combined Treatment of Stage IV Kidney Cancer

Abstract

Introduction. Kidney cancer remains an urgent problem in modern oncology. More than 200 thousand new cases of kidney cancer are diagnosed globally every year, with about 100 thousand patients dying. 15–17% of patients are diagnosed with stage IV kidney cancer. Arterial tumour embolization and nephrectomy are used as a palliative treatment.Aim. To evaluate the results of renal artery embolization in combined treatment of stage IV kidney cancer.Material and methods. The treatment results of 22 patients with stage IV kidney cancer are presented: 6 patients had metastases in the skeletal bones; 15 — metastases in the lungs; 1 — bilateral kidney damage. At the first stage, all patients underwent renal artery embolization. Subsequently, 6 patients received bisphosphonates and radiation therapy for metastases in the skeletal bones, 15 patients underwent operation followed by a targeted therapy with Sunitinib and Sorafenib), 1 patient with bilateral kidney damage underwent operation followed by a 2-year targeted therapy with Sorafenib.Results and discussion. Renal artery embolization was performed successfully without technical difficulties in all the patients. After embolization, hemostasis was achieved in all patients with hematuria (n = 14). Postembolization syndrome was noted in 13 patients with total renal artery embolization. 6 patients with metastases in the skeletal bones lived for 16.4 ± 2.1 months, the survival time of 15 patients who received renal artery embolization, nephrectomy and targeted therapy was 41.7 ± 15.3 months. Only one patient (bilateral kidney damage) has been under dynamic observation for the period of 10 years.Conclusion. Renal artery embolization is an effective and minimally invasive technical procedure that should be used in the combined treatment of patients with kidney cancer. The combined use of renal artery embolization and subsequent targeted therapy for kidney cancer provide new opportunities for stage IV combined treatment.