BONE METASTASES FROM RENAL-CELL CARCINOMA - PREOPERATIVE EMBOLIZATION

PURPOSE: To assess the effect of preoperative embolization on blood lo ss during surgical repair of bone metastases from renal cell carcinoma and provide long-term follow-up. PATIENTS AND METHODS: Sixteen patien ts with bone metastases underwent preoperative embolization, Polyvinyl alcohol (PVA) particles were used for 13 patients (three with additio nal coils), and coils alone were used in three patients, Surgery was p erformed within 24 hours in four patients, and within 36-120 hours in 12 patients, Bone healing was evaluated radiographically and clinicall y. RESULTS: Tumor stain was obliterated by more than 70% in 12 patient s, 51%-69% in two patients, and less than 50% in two patients, Estimat ed blood loss (EEL) during surgery ranged from 100 to 1,000 mL (mean, 533 mL). EEL was significantly less when more than 70% of the tumor st ain was obliterated (460 mL vs 750 mL; P < .01), There were no signifi cant differences in EEL between the patients who underwent surgery wit hin 24 hours (575 mt) and those who underwent surgery more than 36 hou rs after embolization (402 mL) when PVA was used, Bone healing was ach ieved in all patients, Survival ranged from 3 to 56 months (median, 12 months). CONCLUSION: Preoperative embolization reduced intraoperative blood loss without adverse effects on healing, Best results were achi eved when more than 70% of the tumor stain was obliterated.