Cytoreductive surgery with liver-involved venal cell carcinoma

The purpose of this study was to demonstrate the benefits of cytoreductive surgery for renal cell carcinomas that also involve the liver. Between 1994 and 1997, four patients with renal cell carcinoma with liver involvement w ere surgically treated with nephrectomy and hepatectomy. Two of them underw ent a simultaneous hepatectomy and nephrectomy (group 1), and the remaining two patients underwent a hepatectomy after a nephrectomy and had a diagnos is of postoperative recurrence (group 2). Two patients, one from each group , died of multiple bone metastasis and lung metastasis 30 months and 12 mon ths after the hepatectomy; the second patient from group 1 died 40 months a fter the first operation due to gastrointestinal hemorrhaging. The second p atient from group 2 displayed no evidence of recurrence 18 months after the second surgical procedure. The survival rates for these patients were 66% and 33% at 1 and 3 years, respectively. Autopsy studies revealed that one p atient from group 2 had a local recurrence in the liver while the other two patients from group 1 did not. Our results suggested that a progressive ap proach may therefore be useful for patients demonstrating renal cell carcin oma where there is liver involvement.