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There were a number of studies presented at the European Association of Urology (EAU) Annual Meeting in Amsterdam, the Netherlands, earlier this week about surgery for kidney cancer that has spread (metastatic kidney cancer).
The results from one of the studies suggested that partial nephrectomy may be an acceptable alternative to radical nephrectomy for patients with only a few metastases. This study included 55 people having a partial nephrectomy and 54 having a radical nephrectomy. The people who had partial nephrectomy had a significantly longer 5-year survival compared with those who had radical nephrectomy (32.1 vs 15.5 months). Partial nephrectomy reduced the risk of death by 38% compared to radical nephrectomy in patients with only a few metastases.
Another study showed that a type of stereotactic body radiotherapy (SBRT), called robotic radiosurgery, is safe and effective for lung metastases in kidney cancer patients. This study included 50 kidney cancer patients with lung metastases. Overall survival times were 35 months and the time to when the treatment stopped working and the cancer started growing again was 13 months. All side effects were mild-moderate, proving that robotic radiosurgery is a safe and effective local treatment option for patients with metastatic kidney cancer in the lungs.
A third study looked at the complications of removing metastases using surgery. There were 740 metastases removed from 522 patients. After 30 days, major complications were reported by 8.4% of patients, much lower than what is reported in public registries (as high as 25%). Each 10-year increase in age resulted in an increase in the chance of major complications by 1.5 times. If patients had multiple sites of metastases the chance of major complications was increased 2.4 times compared to patients with just one metastasis. Pancreatic metastases significantly increased major complications 5.7 times.