title: The value of hepatic resection in metastasic renal cancer in the Era of Tyrosinkinase Inhibitor Therapy.
abstract: BACKGROUND
  The value of liver-directed therapy (LDT) in patients with metastasic renal cell carcinoma (MRCC) is still an active field of research, particularly in the era of tyrosinkinase inhibitor (TKI) therapy.
  
  
  METHODS
  The records of 35 patients with MRCC undergoing LDT of metastasic liver lesions between 1992 and 2015 were retrospectively analyzed. Immediate postoperative TKI was given in a subgroup of patients after LDT for metastasic lesions. Uni- and multivariate models were applied to assess overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS).
  
  
  RESULTS
  Following primary tumor (renal cell cancer) resection and LDT, respectively, median OS was better for a total of 16 patients (41 %) receiving immediate postoperative TKI with 151 and 98 months, when compared to patients without TKI therapy with 61 (p = 0.003) and 40 months (p = 0.032). Immediate postoperative TKI was associated with better median PFS (47 months versus 19 months; p = 0.023), whereas in DFS only a trend was observed (51 months versus 19 months; p = 0.110).
  
  
  CONCLUSIONS
  LDT should be considered as a suitable additive tool in the era of TKI therapy of MRCC to the liver. In this context, postoperative TKI therapy seems to be associated with better OS and PFS, but not DFS.
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany. HansMichael.Hau@medizin.uni-leipzig.de.
authors.forename: Hans Michael
authors.initials: HM
authors.lastname: Hau
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Thalmann
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Gastroenterology and Rheumatology, Leipzig University Hospital, Leipzig, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Lübbert
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Mehmet Haluk
authors.initials: MH
authors.lastname: Morgul
authors.affiliation: Department of General, Visceral and Transplant Surgery, Campus Virchow, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Schmelzle
authors.affiliation: Department of General, Visceral and Transplant Surgery, Campus Virchow, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany.
authors.forename: Georgi
authors.initials: G
authors.lastname: Atanasov
authors.affiliation: Department of General, Visceral and Transplant Surgery, Campus Virchow, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Benzing
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Undine
authors.initials: U
authors.lastname: Lange
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Ascherl
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Ganzer
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Uhlmann
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Hans-Michael
authors.initials: HM
authors.lastname: Tautenhahn
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Wiltberger
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bartels
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: Liver resection; Metastasic renal cancer; Tyrosinkinase inhibitor agents