Appleman Leonard J, Maranchie Jodi K
Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA.
Department of Urology, University of Pittsburgh, Pittsburgh, PA.
Urol Oncol. 2018 Jan;36(1):17-22. doi: 10.1016/j.urolonc.2017.06.005. Epub 2017 Jul 20.
Surgical resection for metastatic renal cell carcinoma (RCC) was first described several decades ago, but the appropriate role for surgery in coordinated multidisciplinary care has not been well-defined. The explosive development of new therapies for advanced RCC over the past 10 years has improved the outlook for patients, and there is now renewed interest in surgical metastasectomy for selected patients with metastatic RCC, moving away from the conventional dichotomy between surgery for local disease and systemic therapy for metastatic disease. Patients rendered disease-free after metastasectomy are at high risk of recurrence, but to date no postoperative medical treatment has been shown to be beneficial. Ongoing studies and relevant data will be reviewed to frame the multidisciplinary approach to patients with oligometastatic RCC and to outline future challenges and opportunities for advancing their care.
几十年前首次描述了转移性肾细胞癌（RCC）的手术切除，但手术在多学科协同治疗中的恰当作用尚未明确界定。过去10年中晚期RCC新疗法的迅猛发展改善了患者的预后，目前对于部分转移性RCC患者的手术性转移灶切除术重新产生了兴趣，不再遵循针对局部疾病的手术与针对转移性疾病的全身治疗之间的传统二分法。转移灶切除术后实现无病状态的患者复发风险很高，但迄今为止尚未证明术后药物治疗有益。将对正在进行的研究和相关数据进行综述，以构建针对寡转移性RCC患者的多学科治疗方法，并概述推进其治疗的未来挑战与机遇。
