Treatment of spinal metastases in renal cell carcinoma: A critical review

Kidney cancer is the 9th most common cancer in men and the 14th most common in women worldwide. Renal cell carcinoma (RCC) constitutes 90% of all malignancies of the kidney. RCC, is known to be highly vascular and relatively radioresistant. Bone metastases are one of the most common metastatic sites and occur in around 30% of RCCs. They significantly impact the quality of life of patients causing pain and pathological fractures. Spinal metastases represent a particular case with regard to symptoms and treatment. Indeed, neurological pain is often added to the nociceptive pain caused by metastases. More importantly, neurological impairment can be seen, caused by spinal cord or nerve root compression (MSCC). Due to close contact with the spinal cord, the treatment of spinal bone metastases is challenging and requires a multidisciplinary approach. Specific treatment is currently focused on 4 main avenues which are surgery, radiotherapy, interventional radiology and systemic treatment. In June 2017 we carried out an extensive search on PubMed, Web of Science, and Cochrane Library to review the various treatment options and to establish a treatment strategy. This article presents the result of our critical review of the literature, given our expertise in the field.

Critical reviews in oncology/hematology. 2018 Mar 06 [Epub]

Diego Teyssonneau, Marine Gross-Goupil, Charlotte Domblides, Thibaud Haaser, Vincent Pointillart, Amaury Daste, Olivier Hauger, Alain Ravaud

Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000 Bordeaux, France. Electronic address: ., Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000 Bordeaux, France., Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000 Bordeaux, France; University of Bordeaux, Bordeaux, France., Department of Radiotherapy, Hôpital Haut-Lévêque, Bordeaux University Hospital-CHU Bordeaux, Avenue de Magellan, 33600 Pessac, France., Department of Orthopedic Surgery and Traumatology, Hôpital Pellegrin, Bordeaux University Hospital-CHU Bordeaux,1 Place Amélie Raba Léon, 33076 Bordeaux, France., University of Bordeaux, Bordeaux, France; Department of Diagnostic and Interventional Radiology, Hôpital Pellegrin, Bordeaux University Hospital-CHU Bordeaux, 1 place Amélie Raba Léon, 33076 Bordeaux, France.