Factors Affecting Long-Term Survival Following Pulmonary Metastasectomy of Renal Cell Carcinoma
5 January 2019
Purpose: Role of pulmonary metastasectomy of renal cell carcinoma (RCC) is significant considering its contribution to survival rates. The aim of this study is to present the prognostic factors affecting the surgical outcomes and long-term survival.
Materials and Methods: Forty-eight patients who had undergone pulmonary metastasectomy of RCC between 2000 and 2018 were analyzed in terms of gender, age, subtypes and pathological T stages of RCC, side and size of pulmonary metastases, disease-free interval (DFI) and type of lung resections in order to reveal the prognostic factors from the stand point of selecting suitable patients for lung metastasectomy.
Results: Overall survival was 56.2 ±21.7 months. Survival time was less than 3 years for 7 (14.6%) , between 3 and 5 years for 11 (22.9%) and more than 5 years for 30 (62.5%) patients. Young age, female gender, unilateral pulmonary lesions, longer DFI, lung metastases limited in number and volume were statistically significant for better survival rates (P <.05) whereas subtypes and pathological stage of the primary tumor or the type of pulmonary metastasectomy did not act on the outcomes (P >.05).
Conclusion: The most distinctive factor affecting the surgical outcomes is the complete resection of lung metastases rather than the extent of the surgery. This study clearly states that patients aged under 50 years with unilateral lung metastases counting less than 3 and measuring smaller than 4 cm3 and also DFI lasting longer than 32 months benefit from pulmonary metastasectomy of RCC.
- renal cell carcinoma
- lung metastases
- pulmonary metastasectomy
Hofmann HS, Neef H, Krohe K, et al. Prognostic Fctors and Survival After Pulmonary Resection of Metastatic Renal Cell Carcinoma. European Urology. 2005; 48 : 77-82.
Brufau BP, Cerqueda CS, Villalba LB, et al. Metastatic Renal Cell Carci¬noma: Radiologic Findings and Assessment of Response to Targeted Antiangiogenic Therapy by Using Multidetector CT. RadioGraphics. 2013; 33 : 1691-1716.
Barney JD, Churchill EJ. Adenocarcinoma of The Kidney with Metastases to The Lung: Cured Nephrectomy and Lobectomy. J Urol. 1939; 42 : 269–76.
Gong J, Maia MC, Dizman N, et al. Metastasis in Renal Cell Carcinoma: Biology and Implications for Therapy. Asian J Ur. 2016; 3 : 286-92.
Sadeghi S, Quinn DI. Treatment of Metastatic Renal Cell Carcinoma. American J Hem Onc. 2015; 11(6) : 5-9.
Mejean A, Ravaud A, Thezenas S, et al. Sunitinib Alone or After Nephrectomy in Metastatic Renal-cell Carcinoma. N Engl J Med. 2018; 379(5) : 417-27.
Rodriguez-Vida A, Hutson TE, Bellmunt J, Strijbos M. New Treatment Options for Metastatic Renal Cell Carcinoma. ESMO Open. 2017; 2 : 185-93.
Meacci E, Nachira D, Congedo MT, et al. Lung Metastasectomy Following Kidney Tumors: Outcomes and Prognostic Factors from a Single-center Experience. J Thorac Dis. 2017; 9(12) : 1267-72.
Ku, JY, Kim S, Hong SB, et al. Prognostic Indicators of Pulmonary Metastasis in Patients with Renal Cell Carcinoma Who Have Undergone Radical Nephrectomy. Oncology Letters. 2019; 17(3) : 3009-16.
Assouad J, Petkova B, Berna P, et al. Renal Cell Carcinoma Lung Metastases Surgery: Pathologic Findings and Prognostic Factors. Ann Thoracic Surg. 2007; 84(4) : 114-20.
Dabestani S, Marconi L, Hofmann F, et al. Local Treatments for Metastases of Renal Cell Carcinoma: a Systematic Review. The Lancet Oncology. 2014; 15(12) : 549-61.
Remark R, Alifano M, Cremer I, et al. Characteristics and Clinical Impacts of The Immune Environments in Colorectal and Renal Cell Carcinoma Lung Metastases: Influence of Tumor Origin. Clin Cancer Res. 2013; 19(15) : 4079–91.
Daugherty M, Sedaghatpour D, Shapiro O, et al. The Metastatic Potential of Renal Tumors:Influence of Histologic Subtypes on Definition of Small Renal Masses, Risk Stratification, and Future Active Surveillance Protocols. Urologic Oncology: Seminars and Original Investigations. 2017; 35(153) : 15–20.
- Abstract Viewed: 0 times
- Just Accepted/5927 Downloaded: 0 times