XXXX of the kidney: a clinicopathological study of 9 cases.

@entity1 @entity5 @entity900 @entity1358 @entity136 @entity617 @entity703
PURPOSE: @entity1358 ( @entity1358 ) of the kidney is a rare variant that is associated with an extremely poor prognosis. We report our experience with this variety of @entity5 in the last 9 years. MATERIALS AND METHODS: From 1993 to 2002, 9 @entity1 with @entity1358 were treated at our institution. The diagnosis of @entity1358 was made by a nephrectomy specimen in 8 cases and by renal biopsy in 1. Tumor characteristics, and @entity1 treatment and outcome are reported. RESULTS: At presentation 1 T1N0M0, 1 T3N0M0, 3 T3N+M0 and 4 T3N+M+ @entity5 were seen. Mean followup was 13.6 months. Five @entity1 received no complementary treatment. The @entity1 with the T1N0M0 @entity5 remained free of disease 13 months after nephrectomy and the one with T3N0M0 @entity5 remained free of disease at 17 months. A @entity1 with a T3N+M+ @entity5 experienced progression at 1 month, local recurrence at 17 months and was then lost to followup. The 2 other @entity1 with T3N+M0 and T3N+M+ disease, respectively, progressed rapidly and were lost to followup after 5 months. One @entity1 with a T3N+M0 @entity5 received immunotherapy and died after 24 months, while the other with T3N+M0 disease was treated with oral @entity617 and died after 5 months. Finally, 2 @entity1 with T3N+M+ disease received chemotherapy, consisting of 1,250 mg/m2 gemcitabine on days 1 and 8, and 70 mg/m2 @entity900 on day 1. Each @entity1 achieved an objective response after 3 chemotherapy cycles and remained disease-free 27 and 9 months after nephrectomy, respectively. CONCLUSIONS: @entity1358 is an aggressive @entity703 that is often associated with nodal and visceral metastases at presentation. Our data suggest that combined @entity136 and @entity900 chemotherapy may be the best therapeutic option for @entity1 with this @entity5 .
