-楊啟瑞, 吳錫金, 張兆祥,  歐晏泉, 裘坤元,  李建儀, 王賢祥, 楊晨洸

中國醫藥大學附設醫院泌尿部及台中榮民總醫院泌尿外科

Chi-rei Yang¹, Hsi-chin Wu¹, Chao-hsiang Chang¹, Yen-chuan Ou², Kun-Yuan Chiu², Jian-Ri Li², Shian-Shiang Wang², Cheng-Kuang Yang²

¹ Department of Urology, China Medical University Hospital, Taichung, Taiwan, Division of Urology

²Department of Surgery, Taichung Veterans General Hospital,Taichung, Taiwan

The prognosis of metastatic renal cell carcinoma is dismal. Suntinib is the first approved TKI for metastasectomy (mRCC) with the evidence of improvement in survival. Here we reported the efficacy of metastasectomy in the era of target therapy.

A cohort of 32 patients with mRCC were divided in to two groups, Group I enrolled 16 patients received metastasectomy post radical nephrectomy or some period time following Suntinib therapy. Among them 11 patients received multiple sites resection. Metastasectomy include 10 wedge lung resections,, 5 regional or segmental liver resection, 5 nodal resection, 4 diaphragm resection, 3 bone resection and 2 ovariectomy. Four patients achieve complete resection of metastasectomy were not receive systematic therapy. Group II also enrolled 16 patients who were treated with TKI therapy between 2007 and 2015. The reasons of not receiving surgical excision were surgical ineligible due to multiple sites metastasis (3) and performance score (2).The other 12 surgical eligible patients were self selection or fear of surgical risk. Survival time was using the last follow up date minus the date of diagnosis metastases for both groups. The overall survival and disease specific survival were calculated by using Kaplan Meier’s life-table.

Results: .There was no significant difference regarding the age, sex ratio and comobility..The 2, 3 and 5 year survival rate for Group I (green) were 94, 81 and 50 % and for group II (blue) were 63, 19 and 5 %, respectively.

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Conclusions: aggressive metastases may improve overall survival for patients with mRCC and long term disease free status.