Role of surgery in metastatic renal cell carcinoma.
In summary, although it is associated with only about a 10% 1-year survival, palliative nephrectomy in the rare patient with symptoms directly referable to the primary tumor is justified to reduce patient suffering. However, non-surgical palliation with renal infarction techniques have been shown to produce effective palliation for the majority of symptoms referable to the primary lesion. In patients with resectable low-volume metastases, a combination of nephrectomy with removal of all visible metastases may be expected to result in a 35% 5-year survival rate with some patients displaying long-term survival. Palliative nephrectomy in patients with non-resectable (high volume) metastases can currently only be recommended for patients in whom adjuvant experimental therapy will be employed in addition to nephrectomy. I believe that these patients should be enrolled in carefully controlled and monitored prospective clinical trials.
Flanigan
R C
RC
Department of Urology, Loyola University Medical Center, Struch School of Medicine, Maywood, IL 60153.
D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy; D010166:Palliative Care / Q000379:methods*