Effect of Surgical Resection of Isolated Metastasis from Renal Cell Carcinoma after Targeted Therapy

  Objective  To evaluate the effect of surgical resection of isolated metastases in patients with advanced renal cell carcinoma after targeted therapy.

  Methods  Data were retrospectively collected from 126 patients with metastatic renal cell carcinoma who received targeted therapy in Peking Union Medical College Hospital between December 2007 to December 2013, of whom 16 underwent surgery for distant isolated metastases. All the patients had a confirmed pathological diagnosis of renal cell carcinoma. The targeted therapy involved taking oral drugs including Sorafenib, Sutent, or Everolimus continuously until the isolated metastases were evaluated as stable and resectable. Safety and long-term effect of surgical resection were evaluated.

  Results  The 16 patients included 11 males and 5 females with a median age of 51 (37-72) years. Fourteen cases were renal clear cell carcinomas and 2 were renal papillary cell carcinomas; lung metastasis was found in 5 cases, bone metastasis in 2 cases, adrenal metastasis in 5 cases, brain metastasis in 2 cases, liver metastasis in 1 case, and abdominal wall metastasis in 1 case. In the perioperative period, all the patients recovered well without serious complications. Tumor-related symptoms were relieved after the surgery and the general situation was improved. The 1-, 3-, and 5-year survival of the 16 patients were 75.0%, 43.8%, and 31.3%, respectively. There was no surgery-related mortality.

  Conclusion  Patients with renal cell carcinoma treated with targeted therapy who develop distant isolated metastases may benefit from surgical resection of the metastases, achieving reasonable long-term survival.