Redefining the Role of Surgical Management of Metastatic Renal Cell Carcinoma

被引:4
|
作者
Hsiang, Walter R. [1 ]
Kenney, Patrick A. [1 ,2 ]
Leapman, Michael S. [1 ,2 ]
机构
[1] Yale Univ, Sch Med, New Haven, CT 06510 USA
[2] Yale Univ, Sch Med, Dept Urol, New Haven, CT 06510 USA
关键词
Cytoreductive nephrectomy; Targeted therapy; Cytokine therapy; CARMENA; SURTIME; Immune checkpoint inhibitor; Metastatectomy; CYTOREDUCTIVE NEPHRECTOMY; TARGETED-THERAPY; INTERFERON-ALPHA; PATIENT SURVIVAL; CANCER; INTERLEUKIN-2; EVEROLIMUS; SUNITINIB; VALIDATION; SURGERY;
D O I
10.1007/s11912-020-0895-y
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of Review The treatment landscape for metastatic renal cell carcinoma (mRCC) continues to evolve with ongoing advancements in systemic therapy, raising further questions about the optimal role of surgery in the management of mRCC. Herein, we provide a context and review of the recent evidence concerning the role of surgical therapy for patients with mRCC including cytoreductive nephrectomy and distant metastatectomy. Recent Findings One randomized trial has been published in the targeted therapy era suggesting that initial systemic therapy is non-inferior to cytoreductive nephrectomy among patients with intermediate and poor-risk mRCC. Delaying cytoreductive nephrectomy until after systemic therapy may be a viable treatment approach, although a high level of evidence is lacking. Additional questions remain regarding the sequence of surgery with systemic therapy, utility of distant metastatectomy, as well as the application of these findings to the current generation of immunotherapy. Recent evidence challenges the need of upfront cytoreductive nephrectomy for unselected patients with mRCC. However, surgical therapy continues to play an important role in the management of the disease.
引用
收藏
页数:9
相关论文
共 50 条
  • [1] Redefining the Role of Surgical Management of Metastatic Renal Cell Carcinoma
    Walter R. Hsiang
    Patrick A. Kenney
    Michael S. Leapman
    [J]. Current Oncology Reports, 2020, 22
  • [2] Surgical management of metastatic renal cell carcinoma
    Steinbach, F
    Langbein, S
    Allhoff, EP
    [J]. UROLOGE A, 2000, 39 (04): : 362 - 367
  • [3] Surgical Management of Metastatic Renal Cell Carcinoma
    Ball, Mark W.
    [J]. DISCOVERY MEDICINE, 2017, 23 (129) : 379 - 387
  • [4] Surgical management in metastatic renal cell carcinoma
    Pignot, Geraldine
    [J]. BULLETIN DU CANCER, 2022, 109 (02) : S59 - S65
  • [5] Systemic and surgical management of metastatic renal cell carcinoma
    Kramer, M. W.
    Merseburger, A. S.
    Peters, I.
    Waalkes, S.
    Kuczyk, M. A.
    [J]. UROLOGE, 2012, 51 (02): : 217 - +
  • [6] Renal cell carcinoma metastatic to the pancreas: Results of surgical management
    Taylor A. Sohn
    Charles J. Yeo
    John L. Cameron
    Attila Nakeeb
    Keith D. Lillemoe
    [J]. Journal of Gastrointestinal Surgery, 2001, 5 : 346 - 351
  • [7] Surgical management of pulmonary metastatic lesions in renal cell carcinoma
    Okamoto, T
    Hasegawa, M
    Tanji, S
    Koike, H
    Fujioka, T
    [J]. XXXI WORLD CONGRESS OF THE INTERNATIONAL COLLEGE OF SURGEONS, 1998, : 3 - 7
  • [8] Renal cell carcinoma metastatic to the pancreas: Results of surgical management
    Sohn, TA
    Yeo, CJ
    Cameron, JL
    Nakeeb, A
    Lillemoe, KD
    [J]. JOURNAL OF GASTROINTESTINAL SURGERY, 2001, 5 (04) : 346 - 351
  • [9] Results of surgical management of renal cell carcinoma metastatic to the pancreas
    Kusnierz, Katarzyna
    Mrowiec, Slawomir
    Lampe, Pawel
    [J]. WSPOLCZESNA ONKOLOGIA-CONTEMPORARY ONCOLOGY, 2015, 19 (01): : 54 - 59
  • [10] The role of lymphadenectomy in the surgical management of renal cell carcinoma
    Phillips, CK
    Taneja, SS
    [J]. UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, 2004, 22 (03) : 214 - 223