The Role and Value of Surgery in Metastatic Renal Adenocarcinoma: A Retrospective Clinical Study of 106 Nephrectomized Cases

Abstract

The results of treatment of 106 consecutive nephrectomized cases with metastatic renal adenocarcinoma were analyzed. Over 50% of the patients were dead at 1 year and more than 80% at 2 years from the first metastases. The corresponding 5-year survival rate was 7.3%. Fourteen patients demonstrated a response to radiotherapy, hormonal therapy, cytotoxic drugs, or active specific immunotherapy. The 5-year survival rate of the responders was 14.3% from the first metastases. The 5-year survival rate for 22 patients presenting with only one metastasis was 32%. The corresponding figure for patients presenting with multiple metastases was 1%. Complete excision of metastases was possible in 12 patients, whose 5-year survival rate was 58.3%. All patients with solitary metachronous metastases completely excised lived 5 years or more. It seems that a small number of metastatic renal adenocarcinomas are slow-growing tumors that may simulate a favorable effect of a therapy, but at the same time such disease with nephrectomy, usually with minor tumor burden, in fact may also react better to the treatment, and this feature can cause difficulties in judging the value of any therapy in metastatic renal adenocarcinoma.