title: [Role of nephrectomy in metastatic renal cell carcinoma. Experience of the Department of Urology Juan Canalejo Hospital].
abstract: OBJECTIVE
  We expose our experience in nephrectomy in metastatic renal cell carcinoma, and also show complications, evolution and survival of these patients.
  
  
  METHODS
  We performe a retrospective review of renal cell carcinoma treated at our service in the period between January 1st 1991 and December 31st 2002. We only studied those which presented in a metastatic pattern (31), and divide these in two groups: the ones which were nephrectomized and those which were not. We try to showw the differences between the two groups in order of status performance (E.C.O.G.), associated morbidity and median survival. In the first group we also study complications of surgery and treatment that patients underwent.
  
  
  RESULTS
  we performed nephrectomy in 19 cases, all of them E.C.O.G. 0-1. Median postoperative stay was 12 days, and complication rate was 11.5%. Of these patients, 45% underwent some type of systemic treatment, and median survival was 31 months. We didn't performed nephrectomy in 12 patients, of which 9 were E.C.O.G. 2-3. Associated co-morbidity was higher in this group. Only in three patients any treatment was offered always with palliative reason. Median survival was 3.8 months.
  
  
  CONCLUSIONS
  In those patients with good performance status this approach does not represent more morbility nor mortality than in non-metastatic patients, and that is a cornerstone in their management. We also make a literature review in which we see the last pathways in the management of these patients, and that show the needing for a combined approach both quirurgical and inmunotherapical. We have review with special interest the studie's conclusions of SWOG and EORTC groups.
authors.affiliation: Servicio de Urología, Complejo Hospitalario Universitario Juan Canalejo, La Coruña.
authors.forename: A
authors.initials: A
authors.lastname: Blanco Díez
authors.forename: E
authors.initials: E
authors.lastname: Fernández Rosado
authors.forename: G
authors.initials: G
authors.lastname: Suárez Pascual
authors.forename: I
authors.initials: I
authors.lastname: Rodríguez Gómez
authors.forename: M L
authors.initials: ML
authors.lastname: Ruibal Moldes
authors.forename: S
authors.initials: S
authors.lastname: Novás Castro
authors.forename: F
authors.initials: F
authors.lastname: Gómez Veiga
authors.forename: L
authors.initials: L
authors.lastname: Alvarez Castelo
authors.forename: A
authors.initials: A
authors.lastname: Barbagelata López
authors.forename: J
authors.initials: J
authors.lastname: Ponce Díaz-Reixa
authors.forename: M
authors.initials: M
authors.lastname: González Martín
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary*; D005260:Female; D006757:Hospital Units / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000401:mortality*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014572:Urology / Q000706:statistics & numerical data