title: The Significance of Metastasectomy in Patients with Metastatic Renal Cell Carcinoma in the Era of Targeted Therapy.
abstract: OBJECTIVE
  To investigate the efficacy of surgery in the treatment of metastatic renal cell carcinoma (mRCC) and to identify prognostic factors.
  
  
  METHODS
  A single center retrospective study of 96 patients with mRCC from December 2004 to August 2013.
  
  
  RESULTS
  The median follow-up time was 45 months. Thirty-one (32.3%) of the patients received complete resection of metastatic sites, 11 (11.5%) of the patients underwent incomplete resection of metastatic sites, and 54 (56.3%) of the patients received no surgery. In the univariate Kaplan-Meier analysis, the median overall survival times of the three groups were 52 months, 16 months, and 22 months, respectively (p < 0.001). The difference in the overall survival time was statistically significant between complete resection and no surgery groups (HR = 0.43, p = 0.009), while there was no significant difference between the incomplete metastasectomy and no surgery groups (HR = 1.80, p = 0.102). According to the multivariate Cox regression analysis, complete metastasectomy (HR = 0.49, p = 0.033), T stage > 3 (HR = 1.88, p = 0.015), disease free interval <12 months (HR = 2.34, p = 0.003), and multiorgan involvement (HR = 2.00, p = 0.011) were significant prognostic factors.
  
  
  CONCLUSIONS
  In the era of targeted therapy, complete metastasectomy can improve overall survival. Complete metastasectomy, T stage > 3, disease free interval <12 months, and multiorgan involvement are independent prognostic factors.
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Xiaoteng
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, Peking University First Hospital, Beijing 100034, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Lin
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Cuijian
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Fang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Zhisong
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
authors.forename: Liqun
authors.initials: L
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy / Q000401:mortality*; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult