title: A systematic review of the role of hepatectomy in the management of metastatic renal cell carcinoma.
abstract: OBJECTIVE
  This review sought to systematically appraise the literature to establish the role of hepatectomy in treating renal cell carcinoma hepatic metastases.
  
  
  METHODS
  Medline and EMBASE were systematically searched for papers reporting survival of patients who underwent hepatectomy for metastatic renal cell carcinoma.
  
  
  RESULTS
  Six studies containing 140 patients were included. There were no randomised controlled trials. Perioperative mortality was 4.3%, with reported morbidity between 13 and 30%. Patients with metachronous presentation, and a greater time interval between resection of primary tumour and development of metachronous metastases, appeared to have better survival. There was no difference in survival between patients with solitary and multiple metastases.
  
  
  CONCLUSIONS
  Few patients with hepatic metastases from renal cell carcinoma are suitable for hepatectomy as metastatic disease is usually widespread. Selected patients may experience a survival benefit, but identifying these patients remains difficult.
authors.affiliation: Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, United Kingdom. Electronic address: nggrimes@doctors.net.uk.
authors.forename: N G
authors.initials: NG
authors.lastname: Grimes
authors.affiliation: Altnagelvin Area Hospital, Derry BT47 6SB, Northern Ireland, United Kingdom.
authors.forename: J M
authors.initials: JM
authors.lastname: Devlin
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Liverpool L9 7AL, United Kingdom.
authors.forename: D F J
authors.initials: DF
authors.lastname: Dunne
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Liverpool L9 7AL, United Kingdom.
authors.forename: R P
authors.initials: RP
authors.lastname: Jones
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Liverpool L9 7AL, United Kingdom.
authors.forename: G J
authors.initials: GJ
authors.lastname: Poston
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Liverpool L9 7AL, United Kingdom.
authors.forename: S W
authors.initials: SW
authors.lastname: Fenwick
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Liverpool L9 7AL, United Kingdom.
authors.forename: H Z
authors.initials: HZ
authors.lastname: Malik
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000601:surgery*
keywords: Hepatectomy; Metastatic renal cell carcinoma; Renal cell carcinoma