Pulmonary metastasectomy in patients with renal cell carcinoma: a single-institution experience

Kawashima, Atsunari; Nakayama, Masashi; Oka, Daizo; Sato, Mototaka; Hatano, Koji; Mukai, Masatoshi; Nagahara, Akira; Nakai, Yasutomo; Takayama, Hitoshi; Inoue, Masayoshi; Shiono, Hiroshi; Nishimura, Kazuo; Okumura, Meinoshin; Nonomura, Norio

doi:10.1007/s10147-011-0244-0

Cited by 36 publications

(28 citation statements)

References 27 publications

(49 reference statements)

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“…Tumor size cutoff, as an independent favorable prognostic factor, is still controversial (19,23,26,30) but in our report, 2 cm was a significant cutoff value as in other previous studies (24,32).…”

Section: Resultssupporting

confidence: 56%

“…Additionally, surgical techniques and recent progress in perioperative management allow better prognoses. In our experience only 4 patients (14.8%) had pulmonary synchronous lesions at RCC diagnosis and 63% of patients underwent surgery for single pulmonary metastases, more than reported in literature (47-56%) (19,23,24).…”

Section: Resultsmentioning

confidence: 53%

“…The 5-and 10-year OS from first pulmonary resection was 75% and 59%, respectively, which is encouraging and unawares better than that reported in previous studies (23)(24)(25). In 2008, Chen et al (4) showed a 5-and 10-year OS rate of 83.3% and 41.7%.…”

Section: Resultsmentioning

confidence: 61%

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Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience

et al. 2017

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IntroductionRenal cell carcinoma (RCC) represents approximately 2% of all tumors, and about 30% of patients are affected by metastatic lesions at diagnosis (1,2). About 20% to 40% of patients develops a metastatic disease after nephrectomy (3) and lung is one of the sites most frequently affected by RCC metastases (second after liver) (4). Patients that receive no treatment for metastatic RCC (mRCC) have a 0-18% 5-year survival (5). Nonsurgical therapy for mRCC has limited efficacy, with a median overall survival (OS) reported between 26.4 and 32.0 months (6,7) for mRCC patients receiving several agents targeting angiogenesis or the mTOR pathway, in addition to traditional chemotherapeutic regimens and immunotherapy (8). On the contrary, the 5-year survival rates data published in literature after pulmonary surgery for metastasectomy from 36-54% (9,10), emphasizing the role of surgery as the Background: The lung is one of the sites most frequently affected by metastatic renal cell carcinoma

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Section: Resultssupporting

confidence: 56%

Section: Resultsmentioning

confidence: 53%

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Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience

et al. 2017

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“…Surgical series for pulmonary metastasectomy as a local treatment method of RCC patients report excellent local control (LC) in case of complete resection and promising 3-and 5-year survival rates of 49-66% and 31-58%, respectively (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). However, some RCC patients are medically inoperable due to reduced performance status or comorbidities and some pulmonary metastases are technically not accessible or resectable.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma—a multicenter analysis of the German working group “Stereotactic Radiotherapy”

Hoerner-Rieber¹,

Duma²,

Blanck³

et al. 2017

J. Thorac. Dis.

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Background: Renal cell carcinoma (RCC) is traditionally considered to be radioresistant. Radiotherapy response rates are believed to improve with hypofractionated, high dose stereotactic body radiotherapy (SBRT).However, limited data exist regarding the role of SBRT in the treatment of pulmonary metastases. Methods: The working group "Stereotactic Radiotherapy" of the German Society of Radiation Oncology analyzed its multi-institutional database of more than 700 patients who received SBRT for pulmonary metastases. Treatment was performed at 10 centers between 2001 and 2016. Patients with metastatic RCC were included in the study. Tumor characteristics, treatment details, and follow-up data including survival, local control (LC), distant metastases, and toxicity were evaluated. Results: A total of 46 RCC patients treated with SBRT for 67 lung metastases were identified, who received a median total biologically effective dose (BED iso ) at planning target volume (PTV) isocenter of 117.0 Gy (range, 48.0-189.0 Gy). A median fractional dose of 20.8 Gy at isocenter (range, 6.0-37.9 Gy) was administered in a median number of 3 fractions (1-8 fractions). After a median follow-up time of 28.3 months for all patients, 1-and 3-year LC rates were 98.1% and 91.9%, with corresponding 1-and 3-year overall survival (OS) of 84.3% and 43.8%, respectively. Pulmonary metastases treated with BEDiso ≥130 Gy showed a trend for superior LC (P=0.054). OS was significantly improved in both uni-and multivariate analysis for patients with higher Karnofsky performance scale, lower maximum pulmonary metastasis diameter and lack of post-SBRT systemic therapy due to progression (P=0.014; P=0.049; P=0.006). Only mild acute and late toxicity was reported.

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“…Surgical resection has been reported to result in better survival than systemic chemotherapy in selected patients with metastatic lung cancer [8][9][10]. However, some patients cannot undergo surgery because of poor respiratory function, advanced age, or comorbid disease.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Utility and Safety of Radiofrequency Ablation for Malignant Lung Tumors: Preliminary Results

Hasegawa

Sato

Inaba

et al. 2017

Interventional Radiology

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Purpose: We evaluated the clinical usefulness and safety of radiofrequency ablation (RFA) for the treatment of lung tumors.Materials and Methods: This retrospective study included patients who underwent RFA for the treatment of lung tumors at our institution from March 2006 to April 2015. Technical success, safety, local tumor progression, and survival were evaluated.Results: In total, 41 patients (28 men and 13 women; median age, 69 years; range 37-88 years) with 51 malignant lung tumors measuring 0.6-6.8 cm (mean, 1.71.2 cm) completed 46 planned RFA sessions. Lung tumors were primary in 22 patients and metastatic in 19 patients. Four tumors were not completely surrounded by an ablation zone on computed tomography immediately after RFA (technical success rate; 91.3%, 42/46). One of 41 patients (2.4%) died of pneumonia in the contralateral lung 26 days after RFA. Grade 2 symptomatic pneumothorax (n = 5) and hemothorax (n = 1) and grade 1 asymptomatic pneumothorax (n = 9) occurred during the procedure. Grade 3 pneumonia (n = 1) and grade 2 fever (n = 2) occurred within 30 days of follow-up. During a mean follow-up period of 20.319.1 months, local tumor progression developed in 8 of 51 tumors (15.7%). Eleven patients (26.8%) died of cancer progression (n = 9) or pneumonia (n = 2). The 5-year overall survival rate was 53.5% (95% confidence interval, 31.1-75.9%). Tumor size was a significant prognostic factor on Cox proportional hazards analysis.Conclusion: RFA was a safe and useful treatment option for malignant lung tumors.

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Pulmonary metastasectomy in patients with renal cell carcinoma: a single-institution experience

Cited by 36 publications

References 27 publications

Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience

Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience

Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma—a multicenter analysis of the German working group “Stereotactic Radiotherapy”

The Clinical Utility and Safety of Radiofrequency Ablation for Malignant Lung Tumors: Preliminary Results

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