title: Complete metastasectomy for renal cell carcinoma: Comparison of five solid organ sites.
abstract: OBJECTIVE
  Patients with metastatic RCC can undergo metastasectomy to improve survival time. Our goal was to provide and compare characteristics and oncological outcomes of RCC patients who underwent complete metastasectomy at a single organ site.
  
  
  METHODS
  A total of 138 RCC patients were identified as undergoing complete metastasectomy at a single organ site including adrenal, lung, liver, pancreas, or thyroid. Competing risk regression analysis was used to assess RFS and CSS adjusting for several covariates.
  
  
  RESULTS
  In this highly selected cohort, RFS and CSS was 27% and 84% at 5 years following metastasectomy, respectively. Univariate analysis revealed that removal of multiple tumors, younger age, and a shorter interval between nephrectomy and metastasis was associated with worse RFS. Larger tumors and sarcomatoid histology at nephrectomy was associated with worse CSS. We found no evidence that metastases at the time of RCC diagnosis influenced recurrence or survival. Tumor size, number of metastases resected, and time from nephrectomy to first recurrence was significantly different, but recurrence rates were not found to be significantly different, when compared across all organ sites.
  
  
  CONCLUSIONS
  These findings inform clinical and surgical management of select RCC patients with isolated metastasis to one of several organ sites. J. Surg. Oncol. 2016;114:375-379. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Jakubowski
authors.affiliation: Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Vertosick
authors.affiliation: Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Untch
authors.affiliation: Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sjoberg
authors.affiliation: Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wei
authors.affiliation: Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Frank L
authors.initials: FL
authors.lastname: Palmer
authors.affiliation: Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.affiliation: Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Downey
authors.affiliation: Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Strong
authors.affiliation: Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Paul
authors.initials: P
authors.lastname: Russo
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015331:Cohort Studies; D004701:Endocrine Gland Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D009392:Nephrectomy; D016896:Treatment Outcome
keywords: adrenal; liver; lung; metastasectomy for renal cell carcinoma; pancreas; thyroid