title: Surgical treatment of renal cell cancer liver metastases: a population-based study.
abstract: BACKGROUND
  To evaluate outcomes of surgical treatment in patients with hepatic metastases from renal-cell carcinoma in the Netherlands, and to identify prognostic factors for survival after resection. Renal-cell carcinoma has an incidence of 2,000 new patients in the Netherlands each year (12.5/100,000 inhabitants). According to literature, half of these patients ultimately develop distant metastases with 20% involvement of the liver. Resection of renal-cell carcinoma liver metastases (RCCLM) is performed in only a minority of patients. Hence, little is known about outcome of resectable RCCLM.
  
  
  METHODS
  Patients were retrieved from local databases of the Netherlands Task Force for Liver Surgery (14 centers) and from the Dutch collective pathology database. Survival and prognostic factors were determined by Kaplan-Meier analysis and log rank test.
  
  
  RESULTS
  Thirty-three patients were identified who underwent resection (n = 29) or local ablation (n = 4) of RCCLM in the Netherlands between 1990 and 2008. These patients comprise 0.5% to 1% of the total population of patients diagnosed with RCCLM in that period. There was no operative mortality. The overall survival at 1, 3, and 5 years was 79, 47, and 43%, respectively. Metachronous metastases (n = 23, P = 0.03) and radical resection (n = 19, P < 0.001) were statistically significant prognosticators of overall survival. Size < 50 mm (n = 18, P = 0,54), solitary metastases (n = 19, P = 0.93), and presence of extrahepatic metastases (n = 11, P = 0.28) did not have a statistically significant impact on survival.
  
  
  CONCLUSIONS
  The favorable 5-year survival rate of 43% without operative mortality as found in this nationwide study indicates that selected patients with RCCLM can benefit from surgical treatment.
authors.affiliation: Department of Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Ruys
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Tanis
authors.forename: Iris D
authors.initials: ID
authors.lastname: Nagtegaal
authors.forename: Nagtegaal D
authors.initials: ND
authors.lastname: Iris
authors.forename: Peter
authors.initials: P
authors.lastname: van Duijvendijk
authors.forename: Cornelis
authors.initials: C
authors.lastname: Verhoef
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Porte
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult