Collecting (Bellini) duct carcinoma: A clinical study of a rare tumour and review of the literature

Abstract

Introduction: We report our 15-year experience of Collecting (Bellini) duct carcinoma (CDC). We retrospectively analyzed patient and tumour characteristics, clinical manifestations, surgical techniques, clinical outcomes, and salvage therapies.Methods: From January 1999 to December 2013, 1042 patients underwent surgical resection of renal neoplasm. We examined all renal tumors and identified 10 cases (0.96%) of CDC.Results: The study group included 8 men and 2 women, with a median age of 62.5 years. Of these 10 patients, 9 were symptomatic (90%). All patients were treated with open nephrectomy. The mean tumour size was 5.7 cm. The pathologic stages were distributed as follows: pT1b in 2 patients (20%); pT2a in 1 patient (10%); pT3a in 3 patients (30%); and pT3b in 4 patients (40%). Grading was assessed according to Fuhrman scale as follows: grade II in 1 patient (10%); grade III in 3 patients (30%); grade IV in 5 patients (50%); undetermined grade in 1 patient (10%). Four patients (40%) relapsed locally. The median time of local recurrence was 4.9 months. Distant metastases occurred in 9 patients (90%): 4/9 at the time of diagnosis and 5/9 after nephrectomy. The median time of distant metastases after surgery was 8.1 months. Six patients received chemotherapy (gemcitabine plus platinum salts). Radiotherapy was performed in 5 patients. One patient had surgery because of local recurrence and 2 patients were irradiated in the area of the local recurrence. The median overall survival was 7.6 months, and only 2 patients survived more than 2 years after the nephrectomy.Conclusions: CDCs of the kidney are aggressive and they have a low survival rate. All patients in our study experienced a relapse of their disease. Local recurrence preceded distant metastases. Results of salvage treatments were poor.