Original article: general thoracicPrognostic factors for survival after pulmonary resection of metastatic renal cell carcinoma
Section snippets
Material and methods
From January 1985 to December 1999, 191 patients at our institution with metastatic renal cell carcinoma underwent resection of pulmonary metastases. In all patients, the primary tumor was treated by radical nephrectomy; TNM classification an extend of the tumor less than 4 and showed no extrapulmonary metastatic disease. Patients with a history of renal cell carcinoma and one or more pulmonary nodules were evaluated by physical examination, chest roentgenograms, chest computed tomography (CT)
Results
The 30-day mortality rate was 2.1% (4/191 patients). The causes of death were pulmonary embolism in 2 patients and postoperative hemorrhage in 1 patient. Another patient developed a spontaneous esophageal rupture on the 12th postoperative day and died 29 days after surgery of multi-organ failure.
The follow-up period ranged from 0.1 to 157.8 months, with a median of 21.4 months. Cumulative 5-year survival rate of all patients was 36.9%. Of the prognostic factors analyzed, age, gender, and
Comment
The present study was conducted to describe criteria for selecting patients with isolated pulmonary metastases in an attempt to identify patients who would benefit from surgical resection. In a multivariate analysis of a series of 248 thoracic surgical procedures in 191 patients, the results suggest that a complete surgical resection, disease-free interval, number of metastases, and the presence or absence of thoracic lymph node metastases are all independent significant prognostic factors for
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