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Clin Genitourin Cancer. 2009 Aug;7(2):E39-41. doi: 10.3816/CGC.2009.n.021.

Neoadjuvant sunitinib facilitates nephron-sparing surgery and avoids long-term dialysis in a patient with metachronous contralateral renal cell carcinoma.

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University Hospital Birmingham, NHS Trust, UK.


Bilateral Renal Cell Carcinoma (RCC) is an uncommon clinical entity, affecting 3%-6% of patients with localized RCC. Sunitinib has proven efficacy in the management of metastatic RCC (mRCC), however, there is very limited evidence of primary tumor response. With the changing treatment paradigm, the role of sunitinib should be extended to the neoadjuvant setting, to downstage locally advanced primary renal tumors, to facilitate nephron-sparing surgery (NSS), and to select responding patients with mRCC for continuation of treatment after cytoreductive nephrectomy. The role of sunitinib in downstaging primary renal tumors to facilitate curative NSS has not been previously reported. We report the case of recurrent renal tumors in a solitary kidney, where neoadjuvant sunitinib downstaged the tumors enough to allow NSS.

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