Factors Affecting Long-Term Survival Following Pulmonary Metastasectomy of Renal Cell Carcinoma

Role of pulmonary metastasectomy of renal cell carcinoma (RCC) is significant considering its contri- bution to survival rates. The aim of this study is to present the prognostic factors affecting the surgical outcomes and long-term survival.

Forty-eight patients who had undergone pulmonary metastasectomy of RCC between 2000 and 2018 were analyzed in terms of gender, age, subtypes and pathological T stages of RCC, side and size of pulmonary metastases, disease-free interval (DFI) and type of lung resections in order to reveal the prognostic factors from the stand point of selecting suitable patients for lung metastasectomy.

Overall survival was 56.2 ±21.7 months. Survival time was less than 3 years for 7 (14.6%), between 3 and 5 years for 11 (22.9%) and more than 5 years for 30 (62.5%) patients. Young age, female gender, unilateral pulmonary lesions, longer DFI, lung metastases limited in number and volume were statistically significant for better survival rates (P <.05) whereas subtypes and pathological stage of the primary tumor or the type of pulmo- nary metastasectomy did not act on the outcomes (P >.05).

The most distinctive factor affecting the surgical outcomes is the complete resection of lung metas- tases rather than the extent of the surgery. This study clearly states that patients aged under 50 years with unilat- eral lung metastases counting less than 3 and measuring smaller than 4 cm3 , and also DFI lasting longer than 32 months benefit from pulmonary metastasectomy of RCC.