Long-term Outcome After Resection of Isolated Thoracic Lymph Node Metastases of Renal Cell Cancer

Sponholz, Stefan; Schirren, Moritz; Oguzhan, S.; Mese, Mesut; Schirren, J.

doi:10.1016/j.athoracsur.2019.07.054

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…Complete metastasectomy, in addition to radical nephrectomy, resulted in a significantly improved median OS of 51.3 months, compared to both non-surgically treated and CN groups. This adds to the current evidence concerning the advantages of metastasectomies in the treatment of mRCC, when all macroscopic tumors are extirpable [ 20 – 22 ]. In the multivariable adjusted analyses, we observed a statistically significant OS benefit gained by both CN and surgery with a curative purpose.…”

Section: Discussionmentioning

confidence: 95%

Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010

et al. 2021

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Background The purpose of this study was to evaluate the effects of cytoreductive nephrectomy (CN) and metastasectomies on the survival of patients with synchronous metastatic renal cell cancer (mRCC) using real-life, population-based national dataset. Methods Nationwide data, including all cases of synchronous mRCC in Finland diagnosed on a 6-year timeframe, based on the Finnish Cancer Registry and complemented with patient records from the treating hospitals, were analyzed. Patients with Eastern Cooperative Oncology Group (ECOG) performance status 3–4 were excluded. Univariate and adjusted multivariable survival analysis were performed, including subgroup analysis for patients with different medical therapies. Nephrectomy complications were also analyzed. Results A total of 732 patients were included in the analysis. CN was performed for 389 (53.1%) patients, whereas 68 (9.3%) patients underwent nephrectomy and metastasectomies of all lesions (surgery with curative intent). Median overall survival (OS) for patients who did not undergo nephrectomy was 5.9 (95% confidence interval [CI] = 4.6–7.2) months. Patients who had a CN had a median OS of 16.6 (95% CI = 14.2–19.1, p < 0.001) months, whereas patients who had surgery with curative intent had a median OS of 51.3 (95% CI = 36.0–66.6, p < 0.001) months. The survival benefit of CN and metastasectomies remained significant in all medical therapy subgroups and in both of the applied multivariable statistical models. Conclusions Surgical treatment of metastatic renal cell cancer is associated with a significant survival benefit in patients with good and moderate performance status, regardless of the chosen medical therapy.

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Section: Discussionmentioning

confidence: 95%

Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010

et al. 2021

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“…Recently, Sponholz et al demonstrated the longterm outcomes after resection of isolated thoracic lymph node metastases of RCC. The study presented that 14 RCC patients were included in the long-term follow-up with a median followup time of 35.5 months (range, 2-108 months), and the 1-, 3-, and 5-year survival rates for 15 RCC patients were 93%, 73%, and 73%, respectively (16). Surprisingly, this is the largest cohort of RCC with isolated thoracic lymph node metastases in the published literature (16).…”

Section: Effective Strategymentioning

confidence: 99%

“…The study presented that 14 RCC patients were included in the long-term follow-up with a median followup time of 35.5 months (range, 2-108 months), and the 1-, 3-, and 5-year survival rates for 15 RCC patients were 93%, 73%, and 73%, respectively (16). Surprisingly, this is the largest cohort of RCC with isolated thoracic lymph node metastases in the published literature (16). In this case, the patient underwent complete resection of the MLN metastasis with video-assisted thoracoscopy, and he has undergone no further therapy since the operation.…”

Section: Effective Strategymentioning

confidence: 99%

Solitary Metastasis in the Mediastinal Lymph Node After Radical Nephrectomy for Clear Cell Renal Cell Carcinoma: A Case Report and Literature Review

et al. 2020

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BackgroundRenal cell carcinoma can metastasize to virtually any anatomical site throughout the body, especially the lung, bone, lymph nodes, liver, and brain. However, it is extremely rare for renal cell carcinoma to metastasize solely to the mediastinal lymph node more than 15 years after radical nephrectomy.Case PresentationThe case we present here is that of a 50-year-old Chinese male with an isolated posterior mediastinal lymph node metastasis of clear cell renal cell carcinoma 16 years after radical nephrectomy. However, based on imaging examination, the mass was clinically misdiagnosed as Castleman’s disease before operation. Following surgical excision of the mass, it was finally judged to be a metastasis from clear cell renal cell carcinoma according to the patient’s medical history and immunohistochemical findings. Currently, there is no clinical or radiological finding the recurrence of metastasis after 10 months of follow-up.ConclusionWe report a case of solitary metastasis in the posterior mediastinal lymph node 16 years after radical nephrectomy for clear cell renal cell carcinoma. Given the long disease-free interval between primary renal cell carcinoma to isolated mediastinal lymph node metastasis, it is important to conduct a lifelong regular follow-up, including thoracic computed tomography. In addition, surgical resection remains the best method of treatment for mediastinal lymph node metastases from clear cell renal cell carcinoma if the metastatic lesion is limited.

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Long-term Outcome After Resection of Isolated Thoracic Lymph Node Metastases of Renal Cell Cancer

Cited by 2 publications

References 30 publications

Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010

Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010

Solitary Metastasis in the Mediastinal Lymph Node After Radical Nephrectomy for Clear Cell Renal Cell Carcinoma: A Case Report and Literature Review

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