Surgical and focal treatment for metastatic renal cell carcinoma: A literature review

Naito, Sei; Kato, Tomoyuki; Tsuchiya, Norihiko

doi:10.1111/iju.14841

Cited by 12 publications

(13 citation statements)

References 75 publications

(226 reference statements)

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“…25 Another study based on the IMDC database reported that patients with synchronous mRCC who had estimated survival times of less than 12 months may not benefit from CN. 26,27 In this study, the negative impact of r-IF on patient survival was also observed in the subanalysis of patients with synchronous mRCC and similarly for those who underwent CN. The limited number of cases did not allow further investigations to discuss the clinical implications of r-IF in the management of patients with synchronous mRCC, and future studies are required for this purpose.…”

Section: Discussionsupporting

confidence: 67%

“…There have been several controversies regarding the treatment strategy for patients with synchronous mRCC, particularly those related to the indication for CN. [25][26][27][28][29] As the clinical implications of CN have been changing along with the advancement of systemic therapy for mRCC, an immediate CN is currently considered to be a treatment option restricted only to patients with good performance status, few IMDC risk factors, and a limited metastatic burden. 25 Another study based on the IMDC database reported that patients with synchronous mRCC who had estimated survival times of less than 12 months may not benefit from CN.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic impact of the radiological infiltrative feature of primary renal tumor in metastatic renal cell carcinoma

et al. 2023

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ObjectivesRecent studies suggest that the radiological infiltrative feature (r‐IF) of renal tumors is strongly correlated with poor oncologic outcomes in locally advanced renal cell carcinoma (RCC). This study investigated the prognostic impact of r‐IF of primary renal tumors in metastatic RCC (mRCC) in comparison with International Metastatic RCC Database Consortium (IMDC) risk model.MethodsWe retrospectively analyzed 91 patients with previously untreated mRCC. Dynamic computed tomography of the primary renal tumor was reviewed to assess r‐IF, defined as a focally/extensively ill‐defined tumor interface with normal renal parenchyma.ResultsThe median age was 67 years, and 69 patients (76%) were men. Prior nephrectomy was performed in 47 patients (52%). The median size of the primary renal tumor was 6.7 cm, and 50 patients (55%) presented with cT3–4 stage. Overall, 25 (28%)/52 (57%)/14 (15%) patients were classified into IMDC favorable/intermediate/poor‐risk groups, respectively. An image review identified r‐IFs in the primary renal tumor in 40 patients (44%). The incidences of r‐IFs were 28%/46%/64% in IMDC favorable/intermediate/poor‐risk groups, respectively. During a median follow‐up of 2.6 years, 31 patients (34%) died of RCC. On multivariable analysis, r‐IF and IMDC intermediate‐poor risks were independently associated with poor cancer‐specific survival (CSS). Two‐year CSS were 64%/87% in patients with/without r‐IF, respectively. C‐index was improved from 0.73 to 0.81 by adding r‐IF to the IMDC risk factors.ConclusionsR‐IF of the primary renal tumor was an independent risk factor for poor CSS in patients with mRCC, which may improve the prognostic accuracy when combined with the IMDC risk model.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Prognostic impact of the radiological infiltrative feature of primary renal tumor in metastatic renal cell carcinoma

et al. 2023

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“…The clinical implications of cytoreductive nephrectomy (CN) and metastasectomy have changed, however, and in their review article, Naito et al have provided an excellent overview of the evidence on the topic. 2 CN, which historically was supported by randomized trials showing a survival benefit in the cytokine era, has played an important role for patients with mRCC. 3 Nevertheless, based on the recent results from the CARMENA and SURTIME trials, an immediate CN is currently considered to be a treatment option restricted to patients with a good performance status, few International Metastatic Renal Cell Carcinoma Database Consortium risk factors, and a limited metastatic burden.…”

Section: Editorial Commentmentioning

confidence: 99%

“…The clinical implications of cytoreductive nephrectomy (CN) and metastasectomy have changed, however, and in their review article, Naito et al . have provided an excellent overview of the evidence on the topic 2 . CN, which historically was supported by randomized trials showing a survival benefit in the cytokine era, has played an important role for patients with mRCC 3 .…”

mentioning

confidence: 99%

Editorial Comment to Surgical and focal treatment for metastatic renal cell carcinoma: A literature review

Tanaka

Fujii

2022

Int J of Urology

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Trends of metastasisdirected treatments in patients with renal cell carcinoma: a total populationbased analysis in Germany in the era of targeted therapies. Oncol. Res. Treat. 2020; 43: 679-85. 61 Ouzaid I, Capitanio U, Staehler M et al. Surgical metastasectomy in renal cell carcinoma: a systematic review. Eur. Urol. Oncol. 2019; 2: 141-9. 62 Cheung P, Patel S, North SA et al. Stereotactic radiotherapy for oligoprogression in metastatic renal cell cancer patients receiving tyrosine kinase inhibitor therapy: a phase 2 prospective multicenter study. Eur. Urol. 2021; 80: 693-700. 63 De B, Venkatesan AM, Msaouel P et al. Definitive radiotherapy for extracranial oligoprogressive metastatic renal cell carcinoma as a strategy to defer systemic therapy escalation. BJU Int.

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“…For surgical metastasectomy in mRCC, a meta-analysis on 10 studies by Naito and colleagues shows an advantage in OS for patients with complete metastasectomy compared to patients that did not undergo metastasectomy. However, the authors caution, that because all studies were conducted retrospectively, results might be influenced by selection bias ( 13 ). Data on metastasectomy for oligoprogressive disease (OPD) after systemic treatment for mRCC are rare and there are no studies focussing exclusively on surgical treatment of this entity.…”

Section: Introductionmentioning

confidence: 99%

Surgery for thoracic oligoprogression in metastatic renal cell cancer in the era of new systemic therapies

Le¹,

Passlick²,

Schmid³

2023

J Thorac Dis

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Background: Novel systemic therapies have improved response rates and survival in metastatic renal cell cancer (mRCC) and are considered standard of care for this entity. However, complete remission (CR) is rare and often oligoprogression is observed. Here, we analyse the role of surgery for oligoprogressive lesions in mRCC. Methods:We retrospectively analyzed all patients who underwent surgery for thoracic oligoprogressive lesions of mRCC after receiving systemic therapy including immunotherapy, tyrosine kinase inhibitors (TKI), and/or multikinase inhibitors at our institution between 2007 and 2021 regarding treatment modalities, progression-free survival (PFS) and overall survival (OS).Results: Ten patients with oligoprogressive mRCC were included. The median interval between nephrectomy and oligoprogression was 65 months (range, 16-167). Median PFS after surgery for oligoprogression was 10 months (range, 2-29) and median OS after resection 24 months (range, 2-73). In 4 patients, CR was achieved of whom three showed no progression at last follow-up (PFS median 15 months, range, 10-29). In 6 patients, removal of the progressive site resulted in stable disease (SD) for a median of 4 months (range, 2-29), before 4 of them progressed. Conclusions:In selected cases, surgery can lead to sustained disease control in patients with oligoprogressive mRCC after systemic treatment including immunotherapy and novel treatment agents.

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Surgical and focal treatment for metastatic renal cell carcinoma: A literature review

Cited by 12 publications

References 75 publications

Prognostic impact of the radiological infiltrative feature of primary renal tumor in metastatic renal cell carcinoma

Prognostic impact of the radiological infiltrative feature of primary renal tumor in metastatic renal cell carcinoma

Editorial Comment to Surgical and focal treatment for metastatic renal cell carcinoma: A literature review

Surgery for thoracic oligoprogression in metastatic renal cell cancer in the era of new systemic therapies

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