a Medical Oncology Department , Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy.
b Urology Department, Urological Research Institute , Vita-Salute University, San Raffaele Scientific Institute , Milan , Italy.
Expert Rev Anticancer Ther. 2019 Jul;19(7):603-611. doi: 10.1080/14737140.2019.1625772. Epub 2019 Jun 8.
: So far, clinical experiences have proved metastasectomy as the only approach in the setting of metastatic renal cell carcinoma that may achieve the 'no evidence of disease' status, with an associated improvement in survival. : This review aims to summarize the body of knowledge on therapeutic approaches to mRCC, with a specific insight on the role of metastasectomy and on which underlying factors could be good predictors to select patients who may benefit from surgery. In detail, we managed to identify as potential selection criteria: the number of lesions and their site, the DFI, patients' performance status and, most of all, the completeness of resection. : The definition of the optimal treatment strategy of mRCC patients is still an unmet clinical need. The decision-making process about treatment strategy should consider specific tumor's and patient's characteristics, as well as the integration of the available therapeutic approaches with the aim to reach the best clinical outcome. We consider multidisciplinary management mandatory in order to tailor the treatment approach according to the patient and disease features. The experience of clinicians may be considered crucial in order to select the best candidates for a multimodal approach.
迄今为止，临床经验已证明，在转移性肾细胞癌中，转移灶切除术是唯一可能达到“无疾病证据”状态并提高生存率的方法。本综述旨在总结转移性肾细胞癌的治疗方法，特别关注转移灶切除术的作用以及哪些潜在因素可以作为选择可能从手术中获益的患者的良好预测指标。具体而言，我们确定了以下潜在的选择标准：病变数量及其部位、DFI、患者的一般状况，最重要的是，切除的完整性。
确定转移性肾细胞癌患者的最佳治疗策略仍然是一个未满足的临床需求。治疗策略的决策过程应考虑特定的肿瘤和患者特征，以及将可用的治疗方法与实现最佳临床结果的目标相结合。我们认为多学科管理是必要的，以便根据患者和疾病的特点制定治疗方案。临床医生的经验可能是选择最佳的多模式治疗方案的关键因素。
