Kristýna Procházková1, Josef Vodička2, Jakub Fichtl1, Gabriela Krákorová3, Jakub Šebek1, Milena Roušarová4, Petr Hošek5, Sabine D Brookman May6, Ondřej Hes7, Milan Hora8, Vladislav Třeška1. 1. Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia. 2. Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia, vodicka@fnplzen.cz. 3. Department of Pneumology and Phtisiology, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia. 4. Czech National Oncological Register, Pilsen, Czechia. 5. Biomedical Center, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czechia. 6. Department of Urology, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany. 7. Department of Pathology, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia. 8. Department of Urology, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia.
Abstract
INTRODUCTION: Clear cell renal cell carcinoma (ccRCC) is the most common kidney tumor. If feasible, metastasectomy is preferably indicated in metastatic disease. OBJECTIVE: The aim of this study was to determine the outcome of patients after pulmonary metastasectomy (PM). METHODS: PM for ccRCC was performed in 35 patients in the period of January 2001-2019. Clinical characteristics, type of surgery, histopathology results, and follow-up data were recorded. Progression-free survival (PFS) after PM and overall survival (OS) were defined as outcome endpoints. RESULTS: A total of 77 PMs were performed in 35 patients after nephrectomy for ccRCC. The mean size of pulmonary metastasis was 19.0 mm (4-90). With a median follow-up after PM of 79.2 months, the 3- and 5-year OS rates were 63.5 and 44.9%, respectively. The only statistically significant prognostic factor affecting both PFS (p = 0.019) and OS (p = 0.015) was the dimension of pulmonary metastases. CONCLUSIONS: The prognosis of metastatic ccRCC is generally poor, particularly in cases of larger size of metastasis. PM might improve the individual prognosis of patients with lung metastasis even in cases with higher number of metastases, bilaterality, synchronous metastasis, or a short progression-free interval after nephrectomy.
INTRODUCTION:Clear cell renal cell carcinoma (ccRCC) is the most common kidney tumor. If feasible, metastasectomy is preferably indicated in metastatic disease. OBJECTIVE: The aim of this study was to determine the outcome of patients after pulmonary metastasectomy (PM). METHODS: PM for ccRCC was performed in 35 patients in the period of January 2001-2019. Clinical characteristics, type of surgery, histopathology results, and follow-up data were recorded. Progression-free survival (PFS) after PM and overall survival (OS) were defined as outcome endpoints. RESULTS: A total of 77 PMs were performed in 35 patients after nephrectomy for ccRCC. The mean size of pulmonary metastasis was 19.0 mm (4-90). With a median follow-up after PM of 79.2 months, the 3- and 5-year OS rates were 63.5 and 44.9%, respectively. The only statistically significant prognostic factor affecting both PFS (p = 0.019) and OS (p = 0.015) was the dimension of pulmonary metastases. CONCLUSIONS: The prognosis of metastatic ccRCC is generally poor, particularly in cases of larger size of metastasis. PM might improve the individual prognosis of patients with lung metastasis even in cases with higher number of metastases, bilaterality, synchronous metastasis, or a short progression-free interval after nephrectomy.
Authors: Kristyna Prochazkova; Nikola Ptakova; Reza Alaghehbandan; Sean R Williamson; Tomáš Vaněček; Josef Vodicka; Vladislav Treska; Joanna Rogala; Kristyna Pivovarcikova; Kvetoslava Michalova; Maryna Slisarenko; Milan Hora; Michal Michal; Ondrej Hes Journal: Cancers (Basel) Date: 2021-11-24 Impact factor: 6.639