Hofmann et al reported prognostic factors for patients undergoing resection of pulmonary metastases from a renal cell carcinoma. This can help to identify a pateint who may require more aggressive management or who may be a candidate for a novel therapy. The authors are from Martin-Luther University Halle-Wittenberg in Germany.
Patient selection: pulmonary metastases from a renal cell carcinoma
Parameters:
(1) complete resectability of pulmonary metastases
(2) number of risk factors
(3) synchronous vs metachronous metastases
Risk factors:
(1) disease-free interval < 36 months (between resection of renal tumor and metastasectomy.
(2) multiple metastases
Completely Resectable (R0)
Numbr of Risk Factors
Risk Group
5-Year Survival
yes
0
I
52%
yes
1
II
48%
yes
2
III
22%
no
NA
IV
0%
Metasynchronous metastases were associated with a better survival than synchronous metasteases.
Group with the best prognosis:
(1) completely resectable metastases
(2) metachronous metastases
(3) less than 7 metastases (1 best)
(4) disease-free interval >= 36 months
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