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. 2023 Sep;128(4):653-659.
doi: 10.1002/jso.27305. Epub 2023 May 5.

Surgical treatment for pelvic bone metastatic disease from renal cell carcinoma

Guido Scoccianti  1 , Roberto Scanferla  1 , Maurizio Scorianz  1 , Filippo Frenos  1 , Federico Sacchetti  1 , Francesco Muratori  1 , Domenico A Campanacci  1
Affiliations

Surgical treatment for pelvic bone metastatic disease from renal cell carcinoma

Guido Scoccianti et al. J Surg Oncol. 2023 Sep.

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.

Keywords: bone metastatic disease; pelvic metastases; pelvic surgery; renal cell carcinoma.

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References

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