Metastasectomy, intralesional resection, or stabilization only in the treatment of bone metastases from renal cell carcinoma

Langerhuizen, David W. G.; Janssen, Stein J.; Vliet, Quirine M.J. van der; Raskin, Kevin A.; Ferrone, Marco; Hornicek, Francis J.; Schwab, Joseph H.; Lozano-Calderón, Santiago

doi:10.1002/jso.24284

Cited by 29 publications

(26 citation statements)

References 25 publications

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“…However, we found no difference between the curettage group and the en‐bloc group in terms of the rate of re‐treatment (54% [21/39] vs 44% [4/9], respectively, P = 0.933) or re‐operation (26% [10/39] vs 22% [2/9], respectively, P = 0.711). This is similar to the observation made by Langerhuizen et al No difference in complication rates between the two groups was seen; 18% (12/66) of patients who underwent wide resection developed complications compared to 13% (30/235) of patients who underwent curettage.…”

Section: Discussionsupporting

confidence: 91%

“…vs 44%[4/9], respectively, P = 0.933) or re-operation (26% [10/39] vs 22% [2/9], respectively, P = 0.711). This is similar to the observation made by Langerhuizen et al21 No difference in complication rates between the…”

supporting

confidence: 93%

“…This finding was consistent across the various primary cancer types in this study. The importance of surgical margin on LR after bone metastasis surgery has been shown in renal cell carcinoma . Of note, time to LR showed a trend toward significance as being shorter in the curettage group than in the en‐bloc group (8.9 ± 10.7 months vs 15.5 ± 14.8 months, P = 0.113).…”

Section: Discussionmentioning

confidence: 86%

“…The importance of surgical margin on LR after bone metastasis surgery has been shown in renal cell carcinoma. 4,21,22 Of note, time to LR showed a trend toward significance as being shorter in the curettage group than in the en-bloc group (8.9 ± 10.7 months vs 15.5 ± 14.8 months, P = 0.113). However, we found no difference between the curettage group and the en-bloc group in terms of the rate of re-treatment (54% [21/39] (Table 4).…”

Section: Discussionmentioning

confidence: 93%

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Factors associated with local recurrence after surgery for bone metastasis to the extremities

Krishnan

Kim

Yun

et al. 2017

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 91%

supporting

confidence: 93%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 93%

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Factors associated with local recurrence after surgery for bone metastasis to the extremities

Krishnan

Kim

Yun

et al. 2017

Journal of Surgical Oncology

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“…Systemic therapy is the current standard for patients with mRCC, whereas local management for BM remains controversial. Although to the best of our knowledge radical metastasectomy is the only potentially curative approach and local surgery significantly improves the quality of life (ie, decreases the incidence of SREs and relieves symptoms), the decision to perform surgery for BM depends on a variety of patient‐related features …”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of 168 Chinese patients after local surgery for bone metastases arising from advanced renal cell carcinoma

Dong

Wang

Lü

et al. 2020

Cancer

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BACKGROUND:The effectiveness of local surgery for bone metastases (BM) arising from renal cell carcinoma (RCC) remains uncertain. Herein, the authors performed what to the best of their knowledge is the first investigation of the outcomes of Chinese patients with RCC and BM. METHODS: Data were collected for 168 patients with RCC and BM who were treated at Changzheng Hospital in Shanghai, China, between March 2009 and December 2018. All patients underwent local surgery for BM arising from RCC. Overall survival (OS) was defined as the interval between the date of local surgery and death or last follow-up and was estimated using the Kaplan-Meier method. Univariate and multivariable Cox proportional hazards analyses were used to identify significant prognostic factors. RESULTS:The median OS in the study cohort was 43 months (range, 0-113 months). The 1-year, 3-year, and 5-year survival rates after surgery were 77.4%, 55.9%, and 31.8%, respectively. Univariate analyses demonstrated significant survival differences associated with sex (P = .003), the number of preoperative metastatic sites (BM alone or BM with concomitant metastasis; P < .001), and the number of BM (single or multiple; P = .008). OS also did not appear to differ regardless of whether the patients received postsurgical targeted therapy. Multivariable Cox regression demonstrated that the following characteristics were independent predictors of OS: the number of preoperative metastatic sites, International Metastatic Renal Cell Carcinoma Database Consortium risk score, and Memorial Sloan Kettering Cancer Center score. CONCLUSIONS: Careful patient selection for local surgery is of paramount importance. The prognoses of patients in the Memorial Sloan Kettering Cancer Center-based and International Metastatic Renal Cell Carcinoma Database Consortium-based poor-risk groups were much worse than those of the intermediate-risk groups. In current clinical practice, "stratified treatment" can be performed according to these criteria.

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Surgical treatment for pelvic bone metastatic disease from renal cell carcinoma

Scoccianti

Scanferla

Scorianz

et al. 2023

Journal of Surgical Oncology

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IntroductionPelvic bone metastases from renal cell carcinoma (RCC) are challenging due to their destructive pattern, poor response to radiotherapy and hypervascularity. The purpose of our study was to review a series of patients undergoing surgical treatment with the aim to investigate: 1) survival; 2) local disease control; and 3) complications.MethodsA series of 16 patients was reviewed. A curettage procedure was performed on 12 patients. In eight the lesion involved the acetabulum; a cemented hip arthroplasty with cage was performed in seven; a flail hip in one. Four patients received a resection; in two cases with acetabular involvement, reconstruction was performed with a custom‐made prosthesis and with an allograft and prosthesis.ResultsDisease‐specific survival accounted for 70% at 3 years and 41% at 5 years. Only one local tumor progression after curettage occurred. Revision surgery (flail hip) was necessary for deep infection of the custom‐made prosthesis.ConclusionA prolonged survival in patients affected by bone metastatic disease from RCC can justify also major surgical procedures. Due to a low local progression rate after intralesional procedures, curettage, cement and a total hip arthroplasty with cage, when feasible, should be considered as an alternative to more demanding surgeries like resections and reconstructions.Level of Evidence (Oxford)Level 4.

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Metastasectomy, intralesional resection, or stabilization only in the treatment of bone metastases from renal cell carcinoma

Cited by 29 publications

References 25 publications

Factors associated with local recurrence after surgery for bone metastasis to the extremities

Factors associated with local recurrence after surgery for bone metastasis to the extremities

Clinical outcomes of 168 Chinese patients after local surgery for bone metastases arising from advanced renal cell carcinoma

Surgical treatment for pelvic bone metastatic disease from renal cell carcinoma

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