Revisiting the orthopaedic management of metastatic renal cell carcinoma

Rationale for a more aggressive approach

David S. Geller, Jonathan Morris, Janice Dutcher

Research output: Contribution to journalArticle

Abstract

The treatment and management of renal cell carcinoma (RCC) has recently undergone dramatic changes in every sense, including diagnosis, prognostication, and treatment. Even with these improvements, the incidence of the disease continues to rise, and osseous metastasis remains a challenge in 14% of RCC patients. Building upon the substantial durable response to highdose Interleukin-2 (HD IL-2) and Interferon-[alpha] (IFN-[alpha] combination treatment seen within a subset of patients, novel targeted therapies are rapidly evolving and offering real, albeit incremental, improvements in progression free survival (PFS) and overall survival (OS). These improvements, coupled with the realized benefit of improved diagnostics, more accurate patient stratification schemas, and the development of stereotactic body radiation therapy (SRBT) as amore efficaciousmethod of delivering radiation, underscore the multidisciplinary advancement in the nonoperative management of RCC currently underway. In the context of these advances, the role of the orthopaedic surgeon in the management of the solitary metastases, oligometastatic disease, and disseminated disease may need to be revisited, in so far as to support more aggressive surgical resections and provide more durable and reliable orthopaedic reconstructions while employing all of the multidisciplinary tools available.

Original languageEnglish (US)
Pages (from-to)536-541
Number of pages6
JournalCurrent Orthopaedic Practice
Volume24
Issue number5
DOIs
StatePublished - Sep 2013

Fingerprint

Renal Cell Carcinoma
Orthopedics
Neoplasm Metastasis
Therapeutics
Interferon-alpha
Disease-Free Survival
Interleukin-2
Radiotherapy
Radiation
Survival
Incidence

Keywords

  • Osseous metastases
  • Renal cell carcinoma
  • Surgical management
  • Systemic therapy
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Revisiting the orthopaedic management of metastatic renal cell carcinoma : Rationale for a more aggressive approach. / Geller, David S.; Morris, Jonathan; Dutcher, Janice.

In: Current Orthopaedic Practice, Vol. 24, No. 5, 09.2013, p. 536-541.

Research output: Contribution to journalArticle

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