Key result
Lymph node involvement of primary RCC was a significant predictor of poor overall survival after pulmonary metastasectomy (HR 3.44; 95% CI 1.78-6.67; P=0.001).
Why the study?
What are the prognostic factors for overall survival after pulmonary metastasectomy in patients with renal cell carcinoma?
Meta-Analysis (n=1,447)
What are the prognostic factors for overall survival after pulmonary metastasectomy in patients with renal cell carcinoma?
Hazard Ratio: 3.44 (95% CI 1.78–6.67)
p-value: p=0.001
In patients with pulmonary metastasis from renal cell carcinoma, pulmonary metastasectomy offers potential survival benefits, with outcomes heavily dependent on factors like complete resection and absence of lymph node involvement.
Identified poor prognostic factors may inform patient selection for RCC pulmonary metastasectomy; leaves open need for prospective trials before changing practice.
BACKGROUND: Pulmonary metastasis of Renal cell carcinomas (RCC) is usually considered as a systemic disease. However, some studies revealed potential survival benefits of pulmonary metastasectomies for such patients. The aim of this study was to conduct a systematic review and meta-analysis to assess the prognostic factors for pulmonary metastasectomy of RCC patients. METHODS: An electronic search in MEDLINE, EMBASE, CENTRAL and Chinese BioMedical Literature Database (CBM) were conducted to identify eligible studies. We combined the hazard ratios (HRs) of the identified prognostic factors for overall survival of RCC patients after pulmonary metastasectomy from the eligible studies. RESULTS: Sixteen studies with a total of 1447 patients were included in this meta-analysis. The pooled 1, 3, 5, 10-year overall survival rates for RCC patient after pulmonary metastasectomy were 84%, 59%, 43% and 20%, respectively. The poor prognostic factors were lymph node involvement (LNI) of primary RCC (HR 3.44, 95% confidence interval (CI) 1.78-6.67, P = 0.001), incomplete resection of metastases (HR 3.74, 95% CI 2.49-5.61, P = 0.000), multiple metastases (HR 1.55, 95% CI 1.18-2.03, P = 0.002), larger metastases (HR 1.45, 95% CI 1.26-1.66, P = 0.000), LNI of metastases (HR 3.06, 95% CI 1.52-6.19, P = 0.002), synchronous metastasis (HR 2.49, 95% CI 1.46-4.24, P = 0.001) and short disease free interval (DFI). CONCLUSIONS: Surgery may be a promising treatment for pulmonary metastases of RCC patients. A short DFI, LNI of primary RCC, incomplete resection of metastases, multiple metastases, larger metastases, LNI of metastases and synchronous metastasis are predictors of poor survival after pulmonary metastasectomy for RCC patients.
No takes yet. Share an insight, caveat, or question.
Li et al. (2017) conducted a meta-analysis in Renal cell carcinoma with pulmonary metastasis (n=1,447). Lymph node involvement of primary RCC vs. No lymph node involvement was evaluated on Overall survival (HR 3.44, 95% CI 1.78-6.67, p=0.001). Lymph node involvement of primary RCC was a significant predictor of poor overall survival after pulmonary metastasectomy (HR 3.44; 95% CI 1.78-6.67; P=0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: