title: Targeted therapy after complete resection of metastatic lesions in metastatic renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the efficacy of targeted therapy after complete resection of metastatic lesions in patients with metastatic renal cell carcinoma.
  
  
  METHODS
  We retrospectively reviewed the medical records of 53 patients with metastatic renal cell carcinoma who underwent complete surgical resection of metastatic lesions between January 2006 and December 2012. Immediate postoperative targeted therapy was given to a subgroup of patients. Progression-free survival and cancer-specific survival were assessed.
  
  
  RESULTS
  All patients underwent curative surgery for a primary tumor. A total of 13 patients (24.5%) had metastatic disease at initial diagnosis, and 49 (92.5%) had single-organ involvement at the time of first metastasis. None of the patients met the poor-risk criteria. Of the 19 patients who received immediate postoperative targeted therapy, five (26.3%) experienced relapse. Of the 34 patients who did not receive immediate postoperative targeted therapy, 27 (79.4%) experienced disease recurrence. Targeted therapy was restarted in 30 patients (93.8%) after relapse with excellent disease control rates (complete response: 3.3%, partial response: 36.7%, stable disease: 46.7%). Immediate postoperative targeted therapy was associated with better median progression-free survival (not reached vs 20.0 months; P = 0.017), but not better cancer-specific survival.
  
  
  CONCLUSIONS
  Postoperative targeted therapy after complete metastasectomy seems to be associated with better progression-free survival in patients with metastatic renal cell carcinoma, but not with cancer-specific survival.
authors.affiliation: Department of Urology, School of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Jung
authors.forename: Byung Ki
authors.initials: BK
authors.lastname: Lee
authors.forename: Sangchul
authors.initials: S
authors.lastname: Lee
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Jeong
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009392:Nephrectomy; D011182:Postoperative Care / Q000379:methods*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
chemical_list: D000970:Antineoplastic Agents
keywords: immediate postoperative targeted therapy; metastasectomy; metastatic renal cell carcinoma