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.: Home > Journal of Cancer > 2012 > Volume 3 Number 25 > Russell C. Langan, MD . Surgery Branch, National Cancer Institute / NIH, Building 10 - Hatfield CRC, Room 3 - 3940 , 10 Center Drive, Beth esda, MD 20892

Liver Directed Therapy for Renal Cell Carcinoma

Russell C. Langan, MD . Surgery Branch, National Cancer Institute / NIH, Building 10 - Hatfield CRC, Room 3 - 3940 , 10 Center Drive, Beth esda, MD 20892
Russell.Langan@gmail.com, Fax: 301-451-6905
Abstract :

Background: Metastatic renal cell carcinoma (RCC) to the liver portrays a poor prognosis and liver directed therapy remains controversial. We aimed to determine potential selection criteria for patients who might benefit from this strategy.

Materials and Methods: We evaluated 247 consecutive patients with RCC metastatic to the liver from a prospectively maintained database.

Results: Eighteen patients received liver directed therapy (18/247, 7%). Ten patients underwent liver resection (10/247, 4%) and eight patients underwent radiofrequency ablation (RFA, 8/247, 3%). All were rendered free of disease in the liver. Five had synchronous liver disease and underwent synchronous resections with their primary. Mortality was 0%. Fourteen had single (surgery 7, RFA 7) and four (surgery 3, RFA 1) had multiple liver lesions, respectively. Median size of lesions was 5cm (0.5 - 10cm) and 2.5cm (1 - 6cm) in the surgery and RFA groups, respectively. Median DFI was 10 months, and no difference was observed in those with a longer vs. shorter than median DFI (p = 0.95); liver specific progression free survival for the surgery and RFA groups were 4 and 6 months, respectively (p= 0.93). 1, 3 and 5-year actuarial survivals for the whole group were 89%, 40%, 27%. Median survival for the surgery group was 24 (3 to 254+) months, and for the RFA group 15.6 (7-56+) months (p = 0.56). Metachronous liver disease was associated with prolonged survival (p = 0.02).

Conclusions: Liver directed therapy for RCC is safe. For highly selected patients with metachronous liver RCC metastases, liver directed therapy should be considered in a multidisciplinary manner.

Keywords :
liver resection; metastatic renal cell carcinoma; liver metastases; radiofrequency abl a- tion

Date Deposited : 05 Jan 2015 13:15

Last Modified : 16 Jan 2015 10:46

Official URL: http://www.jcancer.org/

Volume 3, Number 25, - 2012

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