title: Pulmonary metastasectomy in patients with renal cell carcinoma: a single-institution experience.
abstract: BACKGROUND
  Pulmonary metastasectomy in patients with renal cell carcinoma (RCC) remains controversial. The purpose of our analysis was to explore the outcome of patients with RCC who underwent pulmonary metastasectomy at our institution.
  
  
  METHODS
  We reviewed data on 25 patients who underwent resection of lung metastasis from 1998 to 2008 at our institution.
  
  
  RESULTS
  All patients were treated by radical nephrectomy for primary RCC. Progression-free survival (PFS) ranged from 0.3 to 198.8 months (median 7.4 months), and overall survival (OS) ranged from 2.4 to 198.8 months (median 33.9 months). The 5-year PFS rate was 24.9%, and the OS rate was 35.5%. Although differences in the resectability of the metastasectomy and OS were not significant in univariate or multivariate analyses, the relationship between PFS and the radicality of pulmonary metastasectomy was significant in both the univariate and multivariate analyses (P = 0.004, 0.012, respectively).
  
  
  CONCLUSIONS
  The results of pulmonary metastasectomy for patients with RCC at our institution indicate that pulmonary metastasectomy should be performed only when the pulmonary metastasis can be completely resected. Additional studies are therefore necessary to evaluate the prognostic factors and to determine the selection criteria for pulmonary metastasectomy in the new era of molecular-targeted agents.
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Atsunari
authors.initials: A
authors.lastname: Kawashima
authors.forename: Masashi
authors.initials: M
authors.lastname: Nakayama
authors.forename: Daizo
authors.initials: D
authors.lastname: Oka
authors.forename: Mototaka
authors.initials: M
authors.lastname: Sato
authors.forename: Koji
authors.initials: K
authors.lastname: Hatano
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Mukai
authors.forename: Akira
authors.initials: A
authors.lastname: Nagahara
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takayama
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shiono
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nishimura
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D016896:Treatment Outcome