title: Local treatments for metastases of renal cell carcinoma: a systematic review.
abstract: Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefits and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the findings presented here should be interpreted with caution, they and the identified gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.
authors.affiliation: Department of Urology, Skåne University Hospital, Malmö, Sweden.
authors.forename: Saeed
authors.initials: S
authors.lastname: Dabestani
authors.affiliation: Department of Urology, Coimbra University Hospital, Coimbra, Portugal.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Marconi
authors.affiliation: Department of Urology, Sunderby Hospital, Sunderby, Sweden.
authors.forename: Fabian
authors.initials: F
authors.lastname: Hofmann
authors.affiliation: Academic Urology Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Stewart
authors.affiliation: Academic Urology Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Thomas B L
authors.initials: TB
authors.lastname: Lam
authors.affiliation: Division of Urology, University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Canfield
authors.affiliation: Urologische Klinik, Klinikum der Ludwig-Maximilians Universitaet, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Staehler
authors.affiliation: Barts Cancer Institute, Queen Mary University of London, St Bartholomew's Hospital, London, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Powles
authors.affiliation: Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
authors.forename: Börje
authors.initials: B
authors.lastname: Ljungberg
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands. Electronic address: a.bex@nki.nl.
authors.forename: Axel
authors.initials: A
authors.lastname: Bex
mesh_terms: D001859:Bone Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D059146:Metastasectomy; D009362:Neoplasm Metastasis