Clinical Follow-Up Study for Brain Metastases of Renal Cell Carcinoma

ABSTRACT

PURPOSE: We reviewed the records of renal cell carcinoma (RCC) patients with brain metastases, analyzed about survival and prognosis after several palliative management. MATERIALS AND METHODS: Between June 1998 and January 2008, 22 patients diagnosed to have brain metastases from RCC. We retrospectively reviewed their medical records, and analyzed clinical properties. RESULTS: Of 278 patients with RCC, 22 patients (7.9%) diagnosed to have brain metastases. The pathological T stages and Fuhrman nuclear grade of RCC at the time of initial diagnosis were various (T1 1 patient, T2 5, T3 8, T4 3, Fuhrman grade 1 0, 2 4, 3 10, 4 6, unknown 2). Most of RCC was clear cell carcinoma (17/22). Most symptoms suggesting brain metastases were neurologic. Median cancer specific survival (CSS) of WBRT, radiosurgery, or surgery group (13/22) was 4 months, conservative management group (9/22) was 1.5 months and CSS of the former group was significantly better. Median duration of development of brain metastasis after diagnosis of RCC was 28 month (1-120). There was no difference in CSS between patients with brain metastasis developed before and after 28 month (p=0.361). CONCLUSIONS: Brain metastases of RCC have poor prognostic course. Development interval of brain metastases did not affect survival. WBRT, radiosurgery or surgery group showed better survival. Active intervention may improve survival.