Macherey S, Kauffmann C, Heidenreich A, Doerr F, Wahlers T, Hekmat K
Medizinische Fakultät, Universität zu Köln, Joseph-Stelzmann-Straße 20, 50931, Köln, Deutschland.
Klinik für Urologie, Uro-Onkologie, spezielle urologische und roboter-assistierte Chirurgie, Universität zu Köln, Kerpener Straße 62, 50931, Köln, Deutschland.
Urologe A. 2017 Aug;56(8):1025-1030. doi: 10.1007/s00120-017-0353-0.
In patients with isolated meta- or synchronous pulmonary metastases from renal cell cancer, lung metastasectomy could be an appropriate treatment option after successful treatment of primary cancer.
Presentation of lung metastasectomy as a treatment option in patients with pulmonary metastatic renal cell cancer and the postoperative outcome. Description of alternative treatment modalities focusing on "targeted therapies".
Systematical literature research and qualitative analysis of studies on patients undergoing lung metastasectomy after primary nephrectomy published since 01 January 2000. We assessed operative findings, survival data, and prognostic factors.
Pulmonary metastasectomy results in a median postmetastasectomy survival of 26-94 months. The 5‑year survival rates vary between 33 and 58%. The patients' prognosis depends on a prolonged disease-free interval and complete resection of all suspected metastases. In particular, number and location of lung metastases should play a minor role for the indication for lung metastasectomy.
Pulmonary metastasectomy should be considered the treatment of choice in selected patients with successfully resected primary cancer showing no evidence of extrapulmonary metastases and having guaranteed operability and complete resection.
对于孤立性或同时性肾细胞癌肺转移患者，在原发性癌症成功治疗后，肺转移瘤切除术可能是一种合适的治疗选择。
介绍肺转移瘤切除术作为肺转移性肾细胞癌患者的一种治疗选择及其术后结果。描述以“靶向治疗”为重点的替代治疗方式。
对2000年1月1日以来发表的关于原发性肾切除术后接受肺转移瘤切除术患者的研究进行系统的文献检索和定性分析。我们评估了手术结果、生存数据和预后因素。
肺转移瘤切除术后的中位生存时间为26至94个月。5年生存率在33%至58%之间。患者的预后取决于无病间期延长和所有可疑转移灶的完全切除。特别是，肺转移灶的数量和位置对肺转移瘤切除术的适应证应起次要作用。
对于原发性癌症成功切除、无肺外转移证据且手术可操作性和完全切除有保证的特定患者，应考虑将肺转移瘤切除术作为首选治疗方法。
