title: [The significance of metastasectomy in patients with metastatic renal cell carcinoma].
abstract: We conducted a retrospective study to clarify the clinical significance of metastasectomy in patients with metastatic renal cell carcinoma (mRCC). Of 83 mRCC patients who were treated at our hospital between 2005 and 2010, 19 patients who underwent metastasectomy during the treatment course were the subjects of the present study. By the purpose and timing of metastasectomy, we classified the 19 patients into three groups : (1) patients who immediately underwent metastasectomy at diagnosis of metastasis (primary group), (2) patients who underwent resection of clinically problematic metastatic lesions for the relief of their symptoms (palliative group), and (3) patients who underwent complete resection of all metastatic lesions after sufficient systemic therapies (consolidation group). In the primary group (n=5), four patients had lung metastasis and one had metastases to limbs and the adrenal gland. Overall survival at 3 years was 100%. In the palliative group (n=4), 3 patients underwent resection of brain metastasis and one underwent resection of skin metastasis. The symptoms associated with metastasis clearly improved. In the consolidation group (n=10), the metastasized organ was the lung in 5 patients, pancreas in 4, and liver in one. Preoperative systemic therapy included sunitinib or sorafenib in 5 patients, interferon-α in 4, and S-1 in one. After metastasectomy, systemic therapies were discontinued in 9 patients, 4 of whom did not experience RCC recurrence, with a median follow-up of 35 months. Overall survival at 3 years was 60%. Metastasectomy would be a good treatment option in patients with mRCC.
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Haruka
authors: H
authors: Miyata
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Nobuo
authors: N
authors: Shinohara
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Norihiro
authors: N
authors: Murahashi
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Kunihiko
authors: K
authors: Tsuchiya
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Naoto
authors: N
authors: Miyajima
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Satoru
authors: S
authors: Maruyama
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Takashige
authors: T
authors: Abe
authors: The Department of Thoracic Surgery, Hokkaido University Hospital.
authors: Kichizo
authors: K
authors: Kaga
authors: The Department of Gastrointesitinal Surgery II, Hokkaido University Graduate School of Medicine.
authors: Satoshi
authors: S
authors: Hirano
authors: The Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine.
authors: Katsuya
authors: K
authors: Nonomura
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies