Abstract
Introduction: Metastasectomy for advanced renal cell carcinoma has been practiced for over 80 years. However, there is uncertainty regarding the clinical benefit of this procedure and the optimum selection of appropriate patients. Materials and Methods: A systematic literature search was conducted according to the PRISMA statement to identify studies that reported outcomes in patients who underwent metastasectomy at any time. Primary endpoints were overall and disease-free survival. Radiation therapy studies were not included. Case reports and series with less than 20 patients were not included. Results: Forty-four studies were identified that met the criteria for inclusion, with a total of 4195 patients. No studies that randomized patients to surgery versus no surgery were identified. Disease-free interval, number of metastatic sites and completeness of resection were prognostic for overall survival in many of the included studies. Seventeen studies included patients with lung metastases only (1465 patients in total). Conclusions: Case series have documented patients with prolonged disease-free interval and survival after metastasectomy. However, without randomized data, the impact of metastasectomy on outcomes in patients with metastatic renal cell carcinoma (mRCC) remains unknown, especially in the evolving landscape of systemic therapies.
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