Pulmonary resection for metastasis from renal cell carcinoma

Abstract

The treatment of metastatic renal cell carcinoma still represents a widely debated issue due to the introduction of several immunotherapies. To confirm again a role for resection of pulmonary metastases for such tumors, we reviewed our institutional experience. Between 1992 and 2007, eight patients with pulmonary metastases from renal cell carcinoma underwent complete pulmonary resection. All patients had undergone curative resection of their primary renal cell carcinomas and also had obtained or had obtainable locoregional control of their primaries. Various perioperative variables were investigated retrospectively. Disease-free interval varied from 25 to 156 months, with a median of 73 months. In three patients, lung metastases were found to be unilateral and solitary. Four patients presented two metastases in the unilateral lungs. One patient showed five metastases in the bilateral lungs. Six patients underwent wedge resection or segmentectomy, while two patients underwent more than lobectomy. Five patients showed recurrence after pulmonary metastasectomy. Five-year and 10-year overall survival rate was 83.3% and 41.7%, respectively, while 3-year and 5-year disease-free survival rate was 35.0% and 17.5%, respectively. Our study suggested that pulmonary metastasectomy for renal cell carcinoma might be well justified.

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

“…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%. While 3-and 5-year disease-free survival rate was 35.0% and 17.5%; this institutional experience was limited to eight highly selected patients with RCC PMs underwent complete pulmonary resection.…”

“…Association between survival and type of therapy was not considered due to a (14). Resective surgery in patients with pulmonary metastases from RCC is associated with 5-year survival rates at least 21-60% in several retrospective studies (4,9,(15)(16)(17)(18)(19)(20)(21)(22) following complete metastasectomy.…”

“…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).…”

Tratamiento quirúrgico de las metástasis del cáncer renal

“…Producen tos, hemoptisis y dolor torácico. Aunque en el 90% de los ocasiones son asintomáticas y se descubren en la radiografía simple de tórax inicial o de control 18 .…”

“…Si bien, la segmentectomía, lobectomía e incluso neumonectomía son posibles. Siempre que sea tolerable funcionalmente 18 .…”