Christopher D Jakubowski1, Emily A Vertosick2, Brian R Untch3, Daniel Sjoberg2, Elizabeth Wei1, Frank L Palmer3, Snehal G Patel4, Robert J Downey5, Vivian E Strong3, Paul Russo1. 1. Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York. 2. Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. 3. Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, New York. 4. Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York. 5. Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Abstract
BACKGROUND AND OBJECTIVES: 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.
BACKGROUND AND OBJECTIVES:Patients with metastatic RCC can undergo metastasectomy to improve survival time. Our goal was to provide and compare characteristics and oncological outcomes of RCCpatients who underwent complete metastasectomy at a single organ site. METHODS: A total of 138 RCCpatients 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 RCCpatients with isolated metastasis to one of several organ sites. J. Surg. Oncol. 2016;114:375-379.
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