Brehmer B, Piper C, Pfister D, Porres D, Heidenreich A
Klinik für Urologie, Universitätsklinikum der RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
Urologe A. 2012 Sep;51(9):1202-8. doi: 10.1007/s00120-012-2872-z.
Metastasectomy prior to or after systemic medical cancer treatment is performed within a multimodal therapeutic approach in metastatic renal cell cancer (mRCC) to improve the prognosis. The role of metastasectomy in mRCC is controversially discussed and the potential therapeutic benefit is unquantifiable. The purpose of the current review is to critically discuss the available data.
A systematic literature search was carried out in the MedLinedatabase to identify original publications, review articles and editorials with respect to metastasectomy in mRCC and the current European guidelines were also taken into consideration.
Metastasectomy is one of the approaches for mRCC recommended in the guidelines in cases of stable disease for at least 3 months, complete resectability of all metastatic lesions independent of the anatomic localization and a good performance status of the patient. The median survival time varies between 35 and 55 months.
In mRCC metastasectomy is an indiviudal therapeutic approach which might be considered for limited metastatic disease and the presence of good prognostic risk factors to improve average survival time. Especially in renal cell cancer metastasectomy should be considered early.
在转移性肾细胞癌(mRCC)的多模式治疗方法中,在全身抗癌治疗之前或之后进行转移灶切除术以改善预后。mRCC中转移灶切除术的作用存在争议,其潜在治疗益处难以量化。本综述的目的是对现有数据进行批判性讨论。
在MedLine数据库中进行系统的文献检索,以识别关于mRCC转移灶切除术的原始出版物、综述文章和社论,并参考当前的欧洲指南。
对于疾病稳定至少3个月、所有转移灶均可完全切除(与解剖位置无关)且患者体能状态良好的情况,转移灶切除术是指南中推荐的mRCC治疗方法之一。中位生存时间在35至55个月之间。
在mRCC中,转移灶切除术是一种个体化的治疗方法,对于局限性转移性疾病且存在良好预后风险因素的患者,可考虑采用该方法以提高平均生存时间。特别是在肾细胞癌中,应尽早考虑转移灶切除术。