LUNG METASTASES OF RENAL-CELL CARCINOMA - RESULTS OF SURGICAL RESECTION

Objective: The research was designed to evaluate the results of surgic al resection of renal lung metastases. Methods: Between 1960 and 1994, 50 consecutive patients underwent resection for pulmonary metastases from renal cell carcinoma. Mean age was 59 years (range: 40-78 years). Mean time between nephrectomy and pulmonary resection was 3 years (ra nge: 0-18 years). Nineteen patients had solitary metastase, 13 multipl e unilateral, and 18 bilateral. Wedge excision was performed in 28 pat ients, segmentectomy in 3, lobectomy in 17, sleeve lobectomy in 1, pne umonectomy in 5 and biopsy in 3. Twelve patients had repeat resection for recurrent metastases. Results: The resection was complete in 45 pa tients. Three patients also had a complete resection of limited extra- pulmonary disease. There was one postoperative death and 3 complicatio ns. Mean follow-up was 42 months without loss of follow-up. The cause of death was always metastatic recurrent disease. Five-year survival i n complete resection was 44%. Only one long survivor was observed in t he case of incomplete resection in a patient who had a complete respon se after adjuvant immunotherapy. Five-year survival for the 12 patient s with repeat resections was similar to the overall survival rate (42% ). Conclusions: Resection of renal lung metastases is a safe and effec tive treatment. No factor influenced the 5-year survival in this serie s except the complete resection. Extra-pulmonary metastases does not c ontra-indicate pulmonary resection. In selected patients, repeat resec tion for recurrent disease is warranted. Copyright (C) 1997 Elsevier S cience B.V.