Resection of metastatic renal cell carcinoma Journal Article
| Authors: | Kavolius, J. P.; Mastorakos, D. P.; Pavlovich, C.; Russo, P.; Burt, M. E.; Brady, M. S. |
| Article Title: | Resection of metastatic renal cell carcinoma |
| Abstract: | Purpose: Resection of solitary metastases from renal cell carcinoma (RCC) is associated with a 5-year survival rate of 35% to 50%. Selection criteria are not well defined. Patients and Methods: We retrospectively analyzed our experience with 278 patients with recurrent RCC from 1980 to 1993. Results: One hundred forty-one of 278 patients underwent a curative metastectomy for their first recurrence (44% 5-year overall survival [OS] rate), 70 patients underwent noncurative surgery (14% 5-year OS rate), and 67 patients were treated nonsurgically (11% 5-year OS rate). Favorable features for survival were a disease-free interval (DFI) greater than 12 months versus 12 months or less (55% v 9% 5-year OS rate; P < .0001), solitary versus multiple sites of metastases (54% v 29% 5-year OS rate; P < .001), and age younger than 60 years (49% v 35% 5-year OS rate; P < .05). Among 94 patients with a solitary metastasis, lung (n = 50; 54% 5-year OS rate) was more favorable than brain (n = 11; 18% 5-year OS rate; P < .05). Survival rates after curative resection of second and third metastases were not different compared with initial metastectomy (46% and 44%, respectively, v 43% 5-year OS rates; P = nonsignificant). Favorable predictors of survival by multivariate analysis included a single site of first recurrence, curative resection of first metastasis, a long DFI, a solitary site of first metastasis, and a metachronous presentation with recurrence. Conclusion: 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. |
| Keywords: | adult; cancer survival; aged; aged, 80 and over; middle aged; cancer surgery; survival rate; retrospective studies; major clinical study; cancer recurrence; metastasis; retrospective study; kidney carcinoma; nephrectomy; carcinoma, renal cell; neoplasm metastasis; multivariate analysis; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 16 |
| Issue: | 6 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1998-06-01 |
| Start Page: | 2261 |
| End Page: | 2266 |
| Language: | English |
| PUBMED: | 9626229 |
| PROVIDER: | scopus |
| DOI: | 10.1200/JCO.1998.16.6.2261 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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