2019 Volume 33 Issue 4 Pages 394-399
It is well-known that renal cell carcinoma has a tendency to undergo hematogenous metastasis, particularly pulmonary metastasis. We retrospectively assessed outcomes and prognostic factors in 23 patients who underwent pulmonary resection of metastases that originated from renal cell carcinoma between September 2002 and March 2015 at the Shizuoka Cancer Center Hospital after radical nephrectomy. Although the 5-year disease-free survival rate was 38.4%, the 5-year overall survival (OS) rate was 91.3%. The 5-year OS rate in patients with segmentectomy/wedge resection was 100.0%, as compared with 60.0% in patients with lobectomy (P=0.01). The 5-year OS rate was 100.0 and 77.8% for patients with peripheral tumors and those with tumors in a central location, respectively (P=0.10). The patients with DFI (disease-free interval) ≥24 months also tended to have a good prognosis (5-year OS for DFI < 24 vs. ≥24 months: 81.3 vs. 100.0%, respectively, P=0.11). Non-surgical treatment for pulmonary metastasis from renal cell carcinoma is not radical, and long-term survival can be expected with pulmonary metastasectomy. In some cases of surgical resection, survival without recurrence is expected. Moreover, surgical treatment may contribute to prolong disease-free survival. Thus, pulmonary metastasectomy may be an effective treatment strategy.
