Treatment of childhood renal cell carcinoma with lymph node metastasis: Two cases and a review of literature

Standard treatment for renal cell carcinoma (RCC) is radical nephrectomy wi th lymph node dissection. Stages I and II have encouraging prognoses, but S tage III with regional lymph node metastasis can be unfavorable. Adjuvant t herapy for pediatric patients with advanced RCC with lymph node involvement or metastatic lesion has not been defined. Advanced pediatric RCC is repor ted in two patients (boys, aged 6 and 9 years: Stage IIIs, Robson; Stage IU , and IV, pTNM classification) treated by nephrectomy and lymph node dissec tion followed by postoperative interferon-a (IFN), that can be used as an a djuvant therapy with side effects such as fever, bone marrow suppression, o r decreased liver function. One is doing well for 7 years, another is suffe red from lung metastases at 3 years after surgery. Although immunotherapy i s expected to improve survival in pediatric patients with advanced RCC, sur gical resection of renal and meta; static tumors remains the standard treat ment. (C) 2000 Wiley-Liss, Inc.