Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Int J Clin Oncol. 2011 Dec;16(6):660-5. doi: 10.1007/s10147-011-0244-0. Epub 2011 May 10.
Pulmonary metastasectomy in patients with renal cell carcinoma (RCC) remains controversial. The purpose of our analysis was to explore the outcome of patients with RCC who underwent pulmonary metastasectomy at our institution.
We reviewed data on 25 patients who underwent resection of lung metastasis from 1998 to 2008 at our institution.
All patients were treated by radical nephrectomy for primary RCC. Progression-free survival (PFS) ranged from 0.3 to 198.8 months (median 7.4 months), and overall survival (OS) ranged from 2.4 to 198.8 months (median 33.9 months). The 5-year PFS rate was 24.9%, and the OS rate was 35.5%. Although differences in the resectability of the metastasectomy and OS were not significant in univariate or multivariate analyses, the relationship between PFS and the radicality of pulmonary metastasectomy was significant in both the univariate and multivariate analyses (P = 0.004, 0.012, respectively).
The results of pulmonary metastasectomy for patients with RCC at our institution indicate that pulmonary metastasectomy should be performed only when the pulmonary metastasis can be completely resected. Additional studies are therefore necessary to evaluate the prognostic factors and to determine the selection criteria for pulmonary metastasectomy in the new era of molecular-targeted agents.
肾细胞癌（RCC）患者的肺转移切除术仍存在争议。我们分析的目的是探讨在我院接受肺转移切除术的 RCC 患者的结果。
我们回顾了 1998 年至 2008 年在我院接受肺转移灶切除术的 25 例患者的数据。
所有患者均因原发性 RCC 接受根治性肾切除术治疗。无进展生存期（PFS）为 0.3 至 198.8 个月（中位数为 7.4 个月），总生存期（OS）为 2.4 至 198.8 个月（中位数为 33.9 个月）。5 年 PFS 率为 24.9%，OS 率为 35.5%。尽管在单变量和多变量分析中，转移切除术的可切除性和 OS 之间的差异无统计学意义，但在单变量和多变量分析中，PFS 与肺转移切除术的根治性之间存在显著关系（P=0.004，0.012）。
我院 RCC 患者肺转移切除术的结果表明，只有当肺转移灶可以完全切除时才应进行肺转移切除术。因此，有必要进一步研究以评估预后因素，并确定分子靶向药物时代肺转移切除术的选择标准。
