Impact of metastasectomy in disseminated renal cell carcinoma [Stellenwert der metastasen-chirurgie beim metastasierten nierenzellkarzinom]

Metastasectomy in patients with renal cell carcinoma has to be considered as a palliative approach for symptomatic metastases (e.g., pathologic fracture) or as a curative aproach in patients with the option for radical resection of all metastases. By modern perioperative management, even extended resections can be performed with limited morbidity and mortality. The survival rate is significantly higher after resection of pulmonary metastases than after resection of extrapulmonary metastases. Solitary metastases show a better prognosis than multiple metastases. Metachronous metastases that develop after a tumor-free interval of at least 12 months after tumor nephrectomy have a better prognosis than earlier metastases. For metastases that are resected with a curative intent, the best long-term results can be achieved after complete or radical resection.