Surgical treatment of liver metastases from kidney cancer: a systematic review

Abstract

Background: Liver metastases are present in 20.3% of metastatic kidney cancers. The aim of this literature review was to assess the efficacy of surgical treatment for hepatic metastasis from kidney cancer. Methods: An extended web search of the literature was independently performed in March 2018 by two authors according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Results: Through electronic searches, we identified 935 potentially relevant citations. Thirteen articles were finally included in the systematic review. Median survival after resection ranged from 15 to 142 months while the 1-, 3-and 5-year overall survival ranged from 69% to 100%, 26% to 83.3% and 0% to 62%, respectively. Median disease-free survival ranged from 7.2 to 27 months. Conclusion: Surgical treatment of hepatic metastases is performed in approximately 1% of patients with liver metastases and in select patients may be potentially curative. Surgical resection of liver metastases from kidney cancer represents a valid option for selected patients with metastatic renal cancer.

Extended hepatic metastasectomy for renal cell carcinoma—new aspects in times of targeted therapy: a single-center experience over three decades

“…We found a median OS of 37.8 months with 1-, 3-, and 5year survival rates (78.9%, 52.6%, and 38.0%, respectively) in line with results reported in a review by Pikoulis and more recently Pinotti et al [7,8]. The published heterogeneous survival (16-142 months) is partially explained by the varying rates of simultaneous extrahepatic disease (0-37%) and the varying rates of major liver resections in reported patient series (14-85.7%) [14][15][16][17].…”

“…Even though high-volume oncologic liver surgery is performing at our institution, our observation period was long, spanning three decades due to the low incidence of resectable RCC liver metastases, like in most reports on the matter [7,8,21]. Since surgical protocols were refined and, even more to the poor prognostic group (3) was worse than in patients allocated to the favorable (1) and intermediate prognostic groups (2); however, without statistical significance (p = 0.595) importantly, systemic therapy has improved over time, we have analyzed our patient series according to the introduction of the tyrosine kinase inhibitor sunitinib for stage IV RCC in Europe in July 2006, taking into account the significant efficiency of targeted therapy [22][23][24].…”

“…Although several reports of beneficial effects of metastasectomy in combination with targeted therapy were published in the past, the specific role of hepatic metastasectomy remains unclear, since only few studies examining the latter included patients resected in the era of targeted therapy [5,8,26]. To our knowledge, Staehler et al were the first and to date only group of authors, that included a control group receiving systemic therapy instead of surgical resection.…”

“…The role of hepatic resection is still a matter of debate: Grimes, Pikoulis, and Pinotti each published reviews on this issue with patient series ranging from 4 to 85 patients [6][7][8].…”

Twenty-year survival after iterative surgery for metastatic renal cell carcinoma: A case report and review of literature

“…LiMs are present in about 20% of patients with mRCC[ 26 , 30 ], are multiple in 75% and associated with extrahepatic disease in 85-90% of patients, respectively[ 46 ]. LiMs have been traditionally associated with poor oncological outcomes, also in patients receiving targeted systemic therapies[ 30 , 46 ].…”