Giant Renal Cell Carcinoma Surgical Challenges and Life Expectancy: A Real-World Analysis of Serial Cases

Abstract

Giant renal cell carcinoma is a rare case. We reported six cases of giant renal cell carcinoma, which required surgical resection of the tumor, including a 9.900 cm³ of encapsulated neoplasm removal. To our knowledge, this is the largest giant clear cell RCC ever reported in Asia. Cytoreductive nephrectomy without targeted therapy was performed in all cases. The most common type in all cases was clear cell carcinoma. From six cases, four patients died during follow-up of more than 6 months. The number of cases that died in our case was related to poor preoperative status performance, while one of the patients had a histopathological sarcomatoid cell result with a poor prognosis. We should consider performing cytoreductive nephrectomy in younger patients, clear-cell histology, good performance status, limited metastatic burden, 3 or less International Metastatic RCC Database Consortium (IMDC) risk factors, responding to presurgical therapy, preferably in high-volume centers. Cytoreductive nephrectomy is not for every patient, and it’s associated with longer survival in well-selected patients.