Role of metastasectomy in the management of renal cell carcinoma

Treatment of metastatic renal cell carcinoma (mRCC) has evolved with the development of a variety of systemic agents; however, these therapies alone rarely lead to a complete response. Complete consolidative surgery with surgical metastasectomy has been associated with improved survival outcomes in...

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Published inFrontiers in surgery Vol. 9; p. 943604
Main Authors Mikhail, Mark, Chua, Kevin J., Khizir, Labeeqa, Tabakin, Alexandra, Singer, Eric A.
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 29.07.2022
Subjects
metastasectomy
Metastatic kidney cancer
metastatic renal cell carcinoma
renal cancer
renal cell carcinoma
Surgery
metastatic renal cell carcinoma
renal cancer
renal cell carcinoma
metastasectomy
Metastatic kidney cancer
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Summary:Treatment of metastatic renal cell carcinoma (mRCC) has evolved with the development of a variety of systemic agents; however, these therapies alone rarely lead to a complete response. Complete consolidative surgery with surgical metastasectomy has been associated with improved survival outcomes in well-selected patients in previous reports. No randomized control trial exists to determine the effectiveness of metastasectomy. Therefore, reviewing observational studies is important to best determine which patients are most appropriate for metastasectomy for mRCC and if such treatment continues to be effective with the development of new systemic therapies such as immunotherapy. In this narrative review, we discuss the indications for metastasectomies, outcomes, factors associated with improved survival, and special considerations such as location of metastasis, number of metastases, synchronous metastases, and use of systemic therapy. Additionally, alternative treatment options and trials involving metastasectomy will be reviewed.
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Specialty Section: This article was submitted to Genitourinary Surgery, a section of the journal Frontiers in Surgery
Reviewed by: Yuzhe Tang, Harvard Medical School, United States Phillip Marks, University Medical Center Hamburg-Eppendorf, Germany Giuseppe Fallara, San Raffaele Hospital (IRCCS), Italy
Edited by: Jeffrey J Leow, Tan Tock Seng Hospital, Singapore
ISSN:2296-875X
2296-875X
DOI:10.3389/fsurg.2022.943604