Abstract
The value of surgical resection of renal cell carcinoma (RCC) liver metastases still remains unclear.
Objective
Of our study was to evaluate the efficacy of liver resection by comparing patients who could have undergone metastasectomy due to limited disease, but refused surgery.
Materials and methods
Eighty-eight patients were identified with liver metastases and indication of surgery between 1995 and 2006. In 68 patients, liver resection was performed, 20 patients denied surgery and served as comparison group. Patients were followed for survival.
Results
Median age was 58. Median amount of liver metastases was 2 (range 1–30). Median follow-up was 26 months (range 1–187). In both groups, 79% received systemic therapy. The 5-year overall survival rate (OSR-5) after metastasectomy was 62.2% ± 11.4% (SEM) with a median survival (MS) of 142 (95% confidence interval (CI) 115–169) months. OSR-5 in the control group was 29.3% ± 22.0% (SEM) with a MS of 27 (95% CI 16–38) months (P = 0.003). MS was 155 (95% CI 133–175) months with metachronous metastases compared to 29 (95% CI 25–33) months in the comparison group (P = 0.001). Low-grade primary RCC had a MS of 155 (95% CI 123–187) months compared to 29 (95% CI 8–50) months without resection (P = 0.0036). High-grade RCC as well as patients with synchronous metastases did not benefit from surgery.
Conclusions
Liver metastasectomy is an independent valuable tool in the treatment of metastatic RCC and significantly prolongs patient’s survival, even if further systemic treatment is necessary. With the evidence given, patients may benefit from liver metastasis resection if technically feasible.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ries LAG, Melbert D, Krapcho M, et al. (2008) SEER Cancer Statistics Review, 1975–2005, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER web site
Janzen NK, Kim HL, Figlin RA, Belldegrun AS (2003) Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am 30:843–852
Staehler M, Haseke N, Schöppler G et al (2007) Modern therapeutic approaches in metastatic renal cell carcinoma. Eur Urol, EAU-EBU update series 5:26–37
Saitoh H (1981) Distant metastasis of renal adenocarcinoma. Cancer 48:1487–1491
Hofmann HS, Neef H, Krohe K, Andreev P, Silber RE (2005) Prognostic factors and survival after pulmonary resection of metastatic renal cell carcinoma. Eur Urol 48:77–81 discussion-2
Piltz S, Meimarakis G, Wichmann M et al (2003) Surgical treatment of pulmonary metastases from renal cancer. Urologe A 42:1230–1237
Stief CG, Jahne J, Hagemann JH, Kuczyk M, Jonas U (1997) Surgery for metachronous solitary liver metastases of renal cell carcinoma. J Urol 158:375–377
Goere D, Elias D (2008) Resection of liver metastases from non-colorectal non-endocrine primary tumours. Eur J Surg Oncol 34(3):281–288
Lang H, Nussbaum KT, Weimann A, Raab R (1999) Liver resection for non-colorectal, non-neuroendocrine hepatic metastases. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen 70:439–446
Elias D, Cavalcanti de Albuquerque A, Eggenspieler P et al (1998) Resection of liver metastases from a noncolorectal primary: indications and results based on 147 monocentric patients. J Am Coll Surg 187:487–493
Weitz J, Blumgart LH, Fong Y et al (2005) Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Ann Surg 241:269–276
Adam R, Chiche L, Aloia T et al (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1, 452 patients and development of a prognostic model. Ann Surg 244:524–535
Staehler M, Haseke N, Schoppler G et al (2006) Therapy strategies for advanced renal cell carcinoma. Urologe A 45:99–110 quiz 1-2
Thelen A, Jonas S, Benckert C et al (2007) Liver resection for metastases from renal cell carcinoma. World J Surg 31:802–807
Alves A, Adam R, Majno P et al (2003) Hepatic resection for metastatic renal tumors: is it worthwhile? Ann Surg Oncol 10:705–710
Reddy SK, Barbas AS, Marroquin CE et al (2007) Resection of noncolorectal nonneuroendocrine liver metastases: a comparative analysis. J Am Coll Surg 204:372–382
Yedibela S, Gohl J, Graz V et al (2005) Changes in indication and results after resection of hepatic metastases from noncolorectal primary tumors: a single-institutional review. Ann Surg Oncol 12:778–785
Bennett BC, Selby R, Bahnson RR (1995) Surgical resection for management of renal cancer with hepatic involvement. J Urol 154:972–974
Johnin K, Nakai O, Kataoka A et al (2001) Surgical management of renal cell carcinoma invading into the liver: radical nephrectomy en bloc with right hepatic lateral sector. Urology 57:975
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Staehler, M.D., Kruse, J., Haseke, N. et al. Liver resection for metastatic disease prolongs survival in renal cell carcinoma: 12-year results from a retrospective comparative analysis. World J Urol 28, 543–547 (2010). https://doi.org/10.1007/s00345-010-0560-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-010-0560-4