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Treatment and survival of osseous renal cell carcinoma metastases
Author(s) -
Evenski Andrea,
Ramasunder Shalini,
Fox William,
Mounasamy Varatharaj,
Temple H. Thomas
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23134
Subject(s) - medicine , renal cell carcinoma , nephrectomy , carcinoma , surgery , cancer , overall survival , kidney cancer , survival analysis , disease , survival rate , kidney , urology , oncology
Background Renal cell carcinoma is the seventh leading cause of cancer deaths. Studies have shown patients with solitary osseous metastases have a better prognosis; however, methods of resection are not well defined. The purpose of this study was to review factors associated with survival and assess the impact of wide versus intralesional management on function and disease‐specific outcomes in patients with renal cell carcinoma metastases. Methods Sixty‐nine patients with 86 osseous renal cell metastases were reviewed. Potential factors associated with survival were evaluated with Kaplan–Meier curves. ANOVA was performed to compare means between groups. Results One year survival for the group was 77% and 32.5% at 5 years. The absence of metastatic disease at presentation, nephrectomy, and pre‐operative status were associated with improved survival. There was a lower rate of local recurrence with wide resection (5%) versus intralesional procedures (27%). Conclusions Improved pre‐operative status, nephrectomy, and metachronous lesions had better overall survival. Wide resection results in decreased local recurrence and revision surgeries. However, it did not reliably predict improved survival. Our recommendation is for individual evaluation of each patient with osseous renal cell carcinoma metastases. Wide excision may be used for resectable lesions to prevent local progression and subsequent surgeries. J. Surg. Oncol. 2012; 106:850–855. © 2012 Wiley Periodicals, Inc.