Resection of metastatic renal cell carcinoma.

Kavolius, Jeffrey; Mastorakos, Dimitrios P.; Pavlovich, Christian P.; Russo, Paul; Burt, M.; Brady, Mary S.

doi:10.1200/jco.1998.16.6.2261

Cited by 512 publications

(329 citation statements)

References 43 publications

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“…Several non-comparative studies suggest that the disease dynamic might be more important than any intervention. Low tumour grade 39 and long metachronous intervals with repeat resection 40 are associated with long survival. No reliable data exist on the proportion of patients with metastatic renal cell carcinoma who would be eligible for local treatment of their metastases.…”

Section: Discussionmentioning

confidence: 99%

Local treatments for metastases of renal cell carcinoma: a systematic review

Dabestani

Marconi

Hofmann

et al. 2014

The Lancet Oncology

288

205

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Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefi ts and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the fi ndings presented here should be interpreted with caution, they and the identifi ed gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.

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Section: Discussionmentioning

confidence: 99%

Local treatments for metastases of renal cell carcinoma: a systematic review

Dabestani

Marconi

Hofmann

et al. 2014

The Lancet Oncology

288

205

View full text Add to dashboard Cite

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“…Patients with widely metastatic disease or who choose not to have surgical intervention can expect a 5-year survival of only 5% to 30%. 35,36 It is likely that surgical intervention for solitary pancreatic metastasis from RCC provides a survival benefit, although such benefit may be due to both the extent of disease and the surgical resection. 5,20,33,37,38 Lung Cancer Lung cancer is the most common cause of cancerrelated death in the United States.13 Lung cancer is typically classified as either small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma), based on pathologic parameters.…”

mentioning

confidence: 99%

Metastatic Disease to the Pancreas and Spleen

Showalter

Hager

Yeo

2008

Seminars in Oncology

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“…Several retrospective studies have suggested that patients undergoing complete resection of isolated metastatic focus may experience long disease-free intervals, with median overall survival rates of 35 % to 50 % in some reports. [1] In metastatic renal cell cancer, surgical management includes the cytoreductive nephrectomy with metastasectomy. But before contemplating surgery with a curative intent the staging investigations other than multiphasic abdomino-pelvic Fig.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Trans-Diaphragmatic Approach for Wedge Resection of the Solitary Ipsilateral Lung Metastasis in Renal Cell Carcinoma

Mittal

Mandhani

Majumdar

2015

Indian J Surg Oncol

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About one third of newly diagnosed renal cell carcinoma (RCC) patients present with synchronous metastatic disease. Twenty to 40 % with localized disease at diagnosis eventually develop metastases. Complete metastasectomy confers five year survival rate of 35 % to 50 %. Traditional thoracic approach for lung metastasectomy carries increased morbidity. We report a less morbid trans-diaphragmatic approach. Right cytoreductive nephrectomy with liver and simultaneous trans-diaphragmatic lung resection was performed with uneventful perioperative course in a 60 year male with metastatic RCC. Trans-diaphragmatic resection of peripheral lung metastasis can be considered electively approach in selective cases of RCC with ipsilateral resectable inferior lung metastases. Keywords Radical nephrectomy . Lung metastasis . Trans-diaphragmatic lung resection Case HistoryA 60-year-old man with good performance status presented with right flank pain and recent onset weight loss and one episode of gross total painless hematuria. He was having (ECOG-0). The contrast enhanced computerised tomography (CECT) scan of abdomen revealed a right renal mass, whole of the kidney was replaced by tumor with synchronous solitary space occupying lesion (SOL) in segment 6 of the right lobe of the liver (4.3X4.1X3.8 cm), plane between liver and the tumor was not discernible. Chest X-ray revealed a coin shaped lesion in right lower zone. The high-resolution computerised tomography of the chest was done and a solitary SOL of 2 X 1.5 cm in the posterior basal segment of the right inferior lung was found. (Fig. 1)There was no evidence of lymphadenopathy and the left kidney was normal. Bone scan done was not suggestive of metastasis. We thus planned a right cyto-reductive nephrectomy with simultaneous liver and lung metastasectomy. As the tumor was large and adherent to the liver and posterior parietal wall, it was decided to do open radical nephrectomy. Procedure was performed under general anesthesia with double lung ventilation in supine position. A bolster was kept under right lower chest to maximize the surgical exposure. After performing right cytoreductive nephrectomy via anterior subcostal incision, liver resection was performed with the help of Ultracision-Harmonic scalpel device (UltraCision, Ethicon Endosurgery, Cincinnati, OH, USA). The renal tumor was stuck to the posteriolateral diaphragm, which was resected and the resultant tear was enlarged to expose the inferior posterior basal lung SOL. Lung metastasis was resected using 11 number knife after taking adequate resection margins, which were secured with 2-0 polygalactin

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Resection of metastatic renal cell carcinoma.

Abstract: Selected patients with recurrent RCC who can undergo a curative resection of their disease have a good opportunity for long-term survival, particularly those with a single site of recurrence and/or a long DFI.

Cited by 512 publications

References 43 publications

Local treatments for metastases of renal cell carcinoma: a systematic review

Local treatments for metastases of renal cell carcinoma: a systematic review

Metastatic Disease to the Pancreas and Spleen

Simultaneous Trans-Diaphragmatic Approach for Wedge Resection of the Solitary Ipsilateral Lung Metastasis in Renal Cell Carcinoma

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