Renal cell carcinoma metastatic to the lung: Potential benefit in the combination of biological therapy and surgery

Purpose: We evaluated outcomes in cases of renal cell carcinoma metastatic to Materials and Methods: We retrospectively evaluated 22 patients treated with surgical resection and 29 treated with biological therapy followed by surgery. Results: At the time of this study 31 patients (61%) were alive, including 15 with no residual disease and 16 with disease. Of the 22 patients treated with surgery without initial biological therapy 12 (55%) were alive at a median followup of 57 months (range 17 to 148) and 19 of the 29 (66%) treated with combination therapy were alive at a median followup of 48 months (range 19 to 78). A total of 19 patients (37%) died of progressive disease. Conclusions: Our results suggest a role for an aggressive surgical approach in select patients with metastatic renal cell carcinoma, and demonstrate that patients who do not achieve a complete response to biological therapy may benefit from surgical resection of residual disease.