Solitary metastases from renal cell carcinoma: A review

Tongaonkar, Hemant; Kulkarni, Jagdeesh N.; Kamat, Murali R.

doi:10.1002/jso.2930490111

Cited by 62 publications

(27 citation statements)

References 12 publications

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“…This result is consistent with other reports focusing on surgical management of a solitary metastasis from RCC. 39,42 Given this longer survival, some authors have advocated en bloc resection, arguing that eradication of the single active site of disease may play a role in improving quality of life and even survival. 2,20,27,29,44 We offer what we believe is the first report providing information about the natural history of surgical patients presenting with a solitary metastasis of RCC to the spine.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma

Tatsui

Suki

Rao

et al. 2014

SPI

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Object Renal cell carcinoma (RCC) frequently metastasizes to the spine, and the prognosis can be quite variable. Surgical removal of the tumor with spinal reconstruction has been a mainstay of palliative treatment. The ability to predict prognosis is valuable when determining the role and magnitude of surgical intervention in cancer patients. To better identify factors affecting survival in patients undergoing surgery for spinal metastasis from RCC, the authors undertook a retrospective analysis of a large patient cohort at a tertiary care cancer center. Methods Relevant clinical data on a consecutive series of patients who had undergone surgery for spinal metastasis of RCC between 1993 and 2007 at The University of Texas MD Anderson Cancer Center were retrospectively reviewed. Demographic data, histopathological grade of primary tumor, timing of spinal surgery relative to diagnosis, treatment history prior to surgery, neurological status, and systemic disease burden were analyzed to determine the impact of these factors on survival outcome. Results The authors identified 267 patients who met the study criteria. Five-year overall survival (OS) after spine tumor resection was 7.8%, with a median OS of 11.3 months (95% CI 9.5–13.0 months). Patients with Fuhrman Grade 4 RCC had a median OS of 6.1 months (95% CI 3.5–8.7 months), which was significantly lower than the 14.3 months (95% CI 9.1–19.4 months) observed in patients with Fuhrman Grade 3 or less RCC (p < 0.001). Patients with preoperative neurological deficits had a median survival of 5.9 months (95% CI 4.1–7.7 months), which was significantly lower than the 13.5 months (95% CI 10.4–16.6 months) observed in patients with a normal neurological examination (p < 0.001). Patients whose spine was the only site of metastasis had a median OS of 19 months (95% CI 9.8–28.2 months) after surgery, significantly longer than the 9.7 months (95% CI 8.1–11.3 months) observed in patients with additional extraspinal metastasis sites (p < 0.001). Patients with nonprogressing extraspinal metastasis (no metastasis, stable, or concurrent) had a median survival of 20.6 months (95% CI 15.1–26.1 months), compared with 5.6 months (95% CI 4.4–6.8 months) in patients with progressing metastasis (p < 0.001). Conclusions The authors identified several factors influencing survival after spine surgery for metastatic spinal RCC, including grade of the original nephrectomy specimen, activity of the systemic disease, and neurological status at the time of surgery. These clinical features may help to identify patients who may benefit from aggressive surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma

Tatsui

Suki

Rao

et al. 2014

SPI

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“…For example, after resection of solitary hepatic metastases of renal cell carcinomas a 5-year survival of 25e35% is described, 29 whereas 5-year survival after hepatic resection of pancreatic metastases is only 8%. 4 These diverging survival rates demonstrate that a general recommendation for hepatic resection of liver metastases is not reasonable.…”

Section: Surgery For Liver Metastases From Ncrc and Nnec Primary Cancersmentioning

confidence: 99%

Hepatic resection of non-colorectal and non-neuroendocrine liver metastases – Survival benefit for patients with non-gastrointestinal primary cancers – A case-controlled study

Slotta

Schuld

Distler

et al. 2014

International Journal of Surgery

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a b s t r a c tPurpose: Whereas resection of colorectal liver metastases is gold standard, there is an ongoing debate on benefit of resection of non-colorectal (NCRC) and non-neuroendocrine (NNEC) liver metastases. Methods: The potential survival benefit of patients undergoing resection of NCRC or NNEC liver metastases was investigated. Data from a prospectively maintained database were reviewed over a 7-year period. KaplaneMeier method was used for the evaluation of outcome following resection. Results: 101 patients underwent 116 surgical procedures for synchronous and metachronous NCRC or NNEC liver metastases with a morbidity of 23% and a mortality of w1%. 11 patients underwent repeated liver resection procedures. Overall 5-year survival after liver resection was 30% depending on primary tumour site. Median survival was significantly increased after resection of hepatic metastases from nongastrointestinal primaries compared to gastrointestinal primaries. Resection of hepatic metastases from non-gastrointestinal primaries resulted in significantly increased median survival compared to exploration only. Patients with hepatic metastases from gastrointestinal primaries did not benefit from hepatic surgery. Conclusion: Hepatic resection for liver metastases from NCRC or NNEC cancers is a save treatment procedure. However, the decision to perform surgery should depend on the primary cancer. Especially patients with liver metastases from non-gastrointestinal primaries profit from hepatic surgery.

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“…When patients with a solitary bone, lung, or brain metastasis are included, between 13% and 35% of patients survived for 5 years. 7,12,15,16,24,25 In a group of 45 patients with osseous metastasis of renal cell carcinoma, Dürr et al 8 found that when metastasis was limited to one location and the latency of metastasis was greater than 12 months, the 5-year survival rate rose to 54%. When only one of these criteria was fulfilled, the 5-year survival rate declined to 17%.…”

Section: Discussionmentioning

confidence: 96%

Endoprosthetic elbow replacement in patients with solitary metastasis resulting from renal cell carcinoma

Rolf

Gohlke

2004

Journal of Shoulder and Elbow Surgery

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Solitary metastases from renal cell carcinoma: A review

Cited by 62 publications

References 12 publications

Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma

Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma

Hepatic resection of non-colorectal and non-neuroendocrine liver metastases – Survival benefit for patients with non-gastrointestinal primary cancers – A case-controlled study

Endoprosthetic elbow replacement in patients with solitary metastasis resulting from renal cell carcinoma

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