Metastatectomy prior to immunochemotherapy for metastatic renal cell carcinoma.

Abstract:

INTRODUCTION:We reviewed our experiences in performing cytoreductive metastatectomy before initiating systemic immunochemotherapy and tried to investigate potential prognostic factors for such an approach. PATIENTS AND METHODS:A retrospective analysis of 57 patients who received interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy for metastatic renal cell carcinoma was conducted. Before undergoing immunochemotherapy, 20 of the 57 patients had received metastatectomy along with nephrectomy (metastatectomy group) and the other 37 nephrectomy alone (non-metastatectomy group). RESULTS:The metastatectomy group demonstrated median disease-specific and progression-free survival of 23 and 13 months, respectively. The patients in the metastatectomy group were identified as having a better performance status and primarily demonstrating pulmonary metastasis compared with those in the non-metastatectomy group. As assessed in the metastatectomy group, factors such as the number of metastatic lesions, completeness of metastatectomy, and location of metastatic lesions (lung only vs. others) were observed to be significantly associated with overall survivals on univariate analysis. CONCLUSIONS:Metastatectomy may still play a significant therapeutic role for metastatic renal cell carcinoma even in the era of immunochemotherapy as part of a multidisciplinary treatment approach in a selected group of patients in adequate general condition who have pulmonary-limited metastasis that can be completely resected.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Lee SE,Kwak C,Byun SS,Gill MC,Chang IH,Kim YJ,Hong SK

doi

10.1159/000091630

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

256-63

issue

3

eissn

0042-1138

issn

1423-0399

pii

91630

journal_volume

76

pub_type

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