Surgical intervention in patients with metastatic renal cancer: metastasectomy and cytoreductive nephrectomy |
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Authors: | Russo Paul O'Brien Matthew Francis |
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Affiliation: | Department of Surgery, Urology Service, Weill Cornell College of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, N Y 10021, USA. russop@mskcc.org |
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Abstract: | For patients with metastatic renal cancer, prognostic factors defined in systemic therapy clinical trials stratify patients into good, intermediate, and poor risk groups with median survival varying from 4 to 13 months. These same factors also stratify patients whose renal cancers were initially resected completely and who then developed subsequent metastatic disease. Metastasectomy performed in low-risk patients was significantly associated with enhanced survival when compared with low-risk patients not undergoing metastasectomy. Two randomized, prospective clinical trials demonstrated a modest survival advantage of approximately 6 months for patients undergoing cytoreductive nephrectomy followed by interferon alfa-2b. Once effective systemic agents are developed, both metastasectomy and cytoreductive nephrectomy will play greater roles in consolidating clinical responses. |
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