Treatment and survival of osseous renal cell carcinoma metastases

Andrea Evenski, Shalini Ramasunder, William Fox, Varatharaj Mounasamy, H. Thomas Temple

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background Renal cell carcinoma is the seventh leading cause of cancer deaths. Studies have shown patients with solitary osseous metastases have a better prognosis; however, methods of resection are not well defined. The purpose of this study was to review factors associated with survival and assess the impact of wide versus intralesional management on function and disease-specific outcomes in patients with renal cell carcinoma metastases. Methods Sixty-nine patients with 86 osseous renal cell metastases were reviewed. Potential factors associated with survival were evaluated with Kaplan-Meier curves. ANOVA was performed to compare means between groups. Results One year survival for the group was 77% and 32.5% at 5 years. The absence of metastatic disease at presentation, nephrectomy, and pre-operative status were associated with improved survival. There was a lower rate of local recurrence with wide resection (5%) versus intralesional procedures (27%). Conclusions Improved pre-operative status, nephrectomy, and metachronous lesions had better overall survival. Wide resection results in decreased local recurrence and revision surgeries. However, it did not reliably predict improved survival. Our recommendation is for individual evaluation of each patient with osseous renal cell carcinoma metastases. Wide excision may be used for resectable lesions to prevent local progression and subsequent surgeries. J. Surg. Oncol. 2012; 106:850-855. © 2012 Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)850-855
Number of pages6
JournalJournal of Surgical Oncology
Volume106
Issue number7
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

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Renal Cell Carcinoma
Neoplasm Metastasis
Survival
Nephrectomy
Therapeutics
Recurrence
Reoperation
Cause of Death
Analysis of Variance
Kidney
Neoplasms

Keywords

  • cancer
  • kidney
  • metastasis
  • renal cell carcinoma
  • resection

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Treatment and survival of osseous renal cell carcinoma metastases. / Evenski, Andrea; Ramasunder, Shalini; Fox, William; Mounasamy, Varatharaj; Temple, H. Thomas.

In: Journal of Surgical Oncology, Vol. 106, No. 7, 01.12.2012, p. 850-855.

Research output: Contribution to journalArticle

Evenski, Andrea ; Ramasunder, Shalini ; Fox, William ; Mounasamy, Varatharaj ; Temple, H. Thomas. / Treatment and survival of osseous renal cell carcinoma metastases. In: Journal of Surgical Oncology. 2012 ; Vol. 106, No. 7. pp. 850-855.
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N2 - Background Renal cell carcinoma is the seventh leading cause of cancer deaths. Studies have shown patients with solitary osseous metastases have a better prognosis; however, methods of resection are not well defined. The purpose of this study was to review factors associated with survival and assess the impact of wide versus intralesional management on function and disease-specific outcomes in patients with renal cell carcinoma metastases. Methods Sixty-nine patients with 86 osseous renal cell metastases were reviewed. Potential factors associated with survival were evaluated with Kaplan-Meier curves. ANOVA was performed to compare means between groups. Results One year survival for the group was 77% and 32.5% at 5 years. The absence of metastatic disease at presentation, nephrectomy, and pre-operative status were associated with improved survival. There was a lower rate of local recurrence with wide resection (5%) versus intralesional procedures (27%). Conclusions Improved pre-operative status, nephrectomy, and metachronous lesions had better overall survival. Wide resection results in decreased local recurrence and revision surgeries. However, it did not reliably predict improved survival. Our recommendation is for individual evaluation of each patient with osseous renal cell carcinoma metastases. Wide excision may be used for resectable lesions to prevent local progression and subsequent surgeries. J. Surg. Oncol. 2012; 106:850-855. © 2012 Wiley Periodicals, Inc.

AB - Background Renal cell carcinoma is the seventh leading cause of cancer deaths. Studies have shown patients with solitary osseous metastases have a better prognosis; however, methods of resection are not well defined. The purpose of this study was to review factors associated with survival and assess the impact of wide versus intralesional management on function and disease-specific outcomes in patients with renal cell carcinoma metastases. Methods Sixty-nine patients with 86 osseous renal cell metastases were reviewed. Potential factors associated with survival were evaluated with Kaplan-Meier curves. ANOVA was performed to compare means between groups. Results One year survival for the group was 77% and 32.5% at 5 years. The absence of metastatic disease at presentation, nephrectomy, and pre-operative status were associated with improved survival. There was a lower rate of local recurrence with wide resection (5%) versus intralesional procedures (27%). Conclusions Improved pre-operative status, nephrectomy, and metachronous lesions had better overall survival. Wide resection results in decreased local recurrence and revision surgeries. However, it did not reliably predict improved survival. Our recommendation is for individual evaluation of each patient with osseous renal cell carcinoma metastases. Wide excision may be used for resectable lesions to prevent local progression and subsequent surgeries. J. Surg. Oncol. 2012; 106:850-855. © 2012 Wiley Periodicals, Inc.

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