TY - JOUR
T1 - Outcome following hepatic resection of metastatic renal tumors
T2 - The Paul Brousse Hospital experience
AU - Aloia, Thomas A.
AU - Adam, René
AU - Azoulay, Daniel
AU - Bismuth, Henri
AU - Castaing, Denis
PY - 2006/4
Y1 - 2006/4
N2 - Background: As many as 50% of patients with renal cell carcinoma (RCC) will develop systemic metastases. When hepatic metastases from RCC present in a resectable distribution, our group and other groups have previously shown that some patients benefit from curative hepatic resection. In this report we update our own experience and summarize the literature published to date on this topic. Patients and methods: From 1982 to 2005, 19 patients (9 men, 10 women, median age 50 years) with hepatic metastases from RCC were treated with hepatic resection at our institution. In 14 (74%) of the 19 patients the presentation of hepatic metastases was metachronous. Seven (37%) patients had been or were simultaneously treated for extrahepatic metastases. The mean tumor number was 2 and the mean diameter of the largest metastasis was 73 mm. Results: Margin-negative resection was achieved in 17 (89%) of 19 cases. Postoperative morbidity and mortality rates were 32% and 5%, respectively. At a median follow-up interval of 26 months, 15 patients recurred with a mean time to recurrence of 12 months. The 3-year and 5-year disease-free survival rates were 25% and 25%, respectively; 3-year and 5-year overall survival rates were 52% and 26%, respectively, with one patient alive 5 years following first hepatectomy. Study factors which predicted prolonged survivals included male sex and maximum tumor diameter ≤5 cm. Discussion: The overall survival rates in our series (3-year, 52%; 5-year, 26%) and in a complete review of the literature (3-year, 24%; 5-year, 18%) indicate that selected patients with hepatic metastases from RCC benefit from hepatic resection.
AB - Background: As many as 50% of patients with renal cell carcinoma (RCC) will develop systemic metastases. When hepatic metastases from RCC present in a resectable distribution, our group and other groups have previously shown that some patients benefit from curative hepatic resection. In this report we update our own experience and summarize the literature published to date on this topic. Patients and methods: From 1982 to 2005, 19 patients (9 men, 10 women, median age 50 years) with hepatic metastases from RCC were treated with hepatic resection at our institution. In 14 (74%) of the 19 patients the presentation of hepatic metastases was metachronous. Seven (37%) patients had been or were simultaneously treated for extrahepatic metastases. The mean tumor number was 2 and the mean diameter of the largest metastasis was 73 mm. Results: Margin-negative resection was achieved in 17 (89%) of 19 cases. Postoperative morbidity and mortality rates were 32% and 5%, respectively. At a median follow-up interval of 26 months, 15 patients recurred with a mean time to recurrence of 12 months. The 3-year and 5-year disease-free survival rates were 25% and 25%, respectively; 3-year and 5-year overall survival rates were 52% and 26%, respectively, with one patient alive 5 years following first hepatectomy. Study factors which predicted prolonged survivals included male sex and maximum tumor diameter ≤5 cm. Discussion: The overall survival rates in our series (3-year, 52%; 5-year, 26%) and in a complete review of the literature (3-year, 24%; 5-year, 18%) indicate that selected patients with hepatic metastases from RCC benefit from hepatic resection.
KW - Hepatic resection
KW - Liver metastases
KW - Outcomes
KW - Renal cancer
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U2 - 10.1080/13651820500496266
DO - 10.1080/13651820500496266
M3 - Article
C2 - 18333255
AN - SCOPUS:33646115435
SN - 1365-182X
VL - 8
SP - 100
EP - 105
JO - HPB
JF - HPB
IS - 2
ER -