Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma.
To investigate the benefits and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the findings presented here should be interpreted with caution, they and the identified gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.
Written by:
Dabestani S, Marconi L, Hofmann F, Stewart F, Lam TB, Canfield SE, Staehler M, Powles T, Ljungberg B, Bex A. Are you the author?
Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Urology, Coimbra University Hospital, Coimbra, Portugal; Department of Urology, Sunderby Hospital, Sunderby, Sweden; Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Division of Urology, University of Texas Medical School at Houston, Houston, TX, USA; Urologische Klinik, Klinikum der Ludwig-Maximilians Universitaet, Munich, Germany; Barts Cancer Institute, Queen Mary University of London, St Bartholomew's Hospital, London, UK; Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden; Department of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands.
Reference: Lancet Oncol. 2014 Nov;15(12):e549-61.
doi: 10.1016/S1470-2045(14)70235-9
PubMed Abstract
PMID: 25439697