SURGERY OF LUNG METASTASES IN RENAL-CELL CARCINOMA

Objective To examine the impact on survival of pulmonary resection in the treatment of renal cell carcinoma that has metastasized to the lun g. Patients and methods From June 1986 to July 1991, 19 patients were submitted to synchronous or asynchronous lung metastasectomy. Histolog ical examination confirmed the presence of lung metastases from renal cell carcinoma in 16 cases (six synchronous and 10 asynchronous with a mean disease-free interval of 23 months). In the other three cases, h istological examination revealed tuberculomas, chondroid hamartoma and foci of anthracosis. Results To date, among the six patients with syn chronous lung metastases, three have died, two are progressing and one has no evident disease after a mean survival of 24 months. Among the 10 patients who underwent surgical resection of metachronous lung meta stases, one has died, three are progressing and six have no evident di sease (mean survival time, 43 months). Conclusion While the presence o f synchronous lung metastases is an unfavourable prognostic factor eve n after surgical removal (five out of six patients died or are in prog ression shortly after metastasectomy), the results after surgery of as ynchronous lung metastases are encouraging, although the real efficacy of this treatment is still to be confirmed.