Yongsheng Zhao1, Jian Li2, Chuan Li2, Jun Fan2, Lunxu Liu3. 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Guoxuexiang, No. 37, Chengdu, 610041, Sichuan, China; Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China. 2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Guoxuexiang, No. 37, Chengdu, 610041, Sichuan, China. 3. Department of Thoracic Surgery, West China Hospital, Sichuan University, Guoxuexiang, No. 37, Chengdu, 610041, Sichuan, China. Electronic address: lunxu_liu@aliyun.com.
Abstract
BACKGROUND: Pulmonary metastasis of Renal cell carcinomas (RCC) is usually considered as a systemic disease. However, some studies revealed potential survival benefits of pulmonary metastasectomies for such patients. The aim of this study was to conduct a systematic review and meta-analysis to assess the prognostic factors for pulmonary metastasectomy of RCC patients. METHODS: An electronic search in MEDLINE, EMBASE, CENTRAL and Chinese BioMedical Literature Database (CBM) were conducted to identify eligible studies. We combined the hazard ratios (HRs) of the identified prognostic factors for overall survival of RCC patients after pulmonary metastasectomy from the eligible studies. RESULTS: Sixteen studies with a total of 1447 patients were included in this meta-analysis. The pooled 1, 3, 5, 10-year overall survival rates for RCC patient after pulmonary metastasectomy were 84%, 59%, 43% and 20%, respectively. The poor prognostic factors were lymph node involvement (LNI) of primary RCC (HR 3.44, 95% confidence interval (CI) 1.78-6.67, P = 0.001), incomplete resection of metastases (HR 3.74, 95% CI 2.49-5.61, P = 0.000), multiple metastases (HR 1.55, 95% CI 1.18-2.03, P = 0.002), larger metastases (HR 1.45, 95% CI 1.26-1.66, P = 0.000), LNI of metastases (HR 3.06, 95% CI 1.52-6.19, P = 0.002), synchronous metastasis (HR 2.49, 95% CI 1.46-4.24, P = 0.001) and short disease free interval (DFI). CONCLUSIONS: Surgery may be a promising treatment for pulmonary metastases of RCC patients. A short DFI, LNI of primary RCC, incomplete resection of metastases, multiple metastases, larger metastases, LNI of metastases and synchronous metastasis are predictors of poor survival after pulmonary metastasectomy for RCC patients.
BACKGROUND: Pulmonary metastasis of Renal cell carcinomas (RCC) is usually considered as a systemic disease. However, some studies revealed potential survival benefits of pulmonary metastasectomies for such patients. The aim of this study was to conduct a systematic review and meta-analysis to assess the prognostic factors for pulmonary metastasectomy of RCCpatients. METHODS: An electronic search in MEDLINE, EMBASE, CENTRAL and Chinese BioMedical Literature Database (CBM) were conducted to identify eligible studies. We combined the hazard ratios (HRs) of the identified prognostic factors for overall survival of RCCpatients after pulmonary metastasectomy from the eligible studies. RESULTS: Sixteen studies with a total of 1447 patients were included in this meta-analysis. The pooled 1, 3, 5, 10-year overall survival rates for RCCpatient after pulmonary metastasectomy were 84%, 59%, 43% and 20%, respectively. The poor prognostic factors were lymph node involvement (LNI) of primary RCC (HR 3.44, 95% confidence interval (CI) 1.78-6.67, P = 0.001), incomplete resection of metastases (HR 3.74, 95% CI 2.49-5.61, P = 0.000), multiple metastases (HR 1.55, 95% CI 1.18-2.03, P = 0.002), larger metastases (HR 1.45, 95% CI 1.26-1.66, P = 0.000), LNI of metastases (HR 3.06, 95% CI 1.52-6.19, P = 0.002), synchronous metastasis (HR 2.49, 95% CI 1.46-4.24, P = 0.001) and short disease free interval (DFI). CONCLUSIONS: Surgery may be a promising treatment for pulmonary metastases of RCCpatients. A short DFI, LNI of primary RCC, incomplete resection of metastases, multiple metastases, larger metastases, LNI of metastases and synchronous metastasis are predictors of poor survival after pulmonary metastasectomy for RCCpatients.
Authors: Barbara Alicja Jereczek-Fossa; Barbara Bortolato; Marianna Alessandra Gerardi; Samantha Dicuonzo; Virginia Maria Arienti; Stefania Berlinghieri; Stefano Bracelli; Michela Buglione; Mariangela Caputo; Gianpiero Catalano; Luigi Franco Cazzaniga; Luigi De Cicco; Nadia Di Muzio; Francesco Romeo Filippone; Andrei Fodor; Davide Franceschini; Paolo Frata; Stefania Gottardo; Giovanni Battista Ivaldi; Antonio Laudati; Stefano Maria Magrini; Elisa Mantero; Ilaria Meaglia; Sara Morlino; Mauro Palazzi; Fabio Piccoli; Paola Romanelli; Marta Scorsetti; Flavia Serafini; Luciano Scandolaro; Riccardo Valdagni; Roberto Orecchia; Paolo Antognoni Journal: Radiol Med Date: 2018-12-15 Impact factor: 3.469