Cargando…

Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment

Renal cell carcinoma (RCC) remains a public health issue and seems to be increasing. A significant proportion of RCC patients will develop pulmonary metastasis at some point in their evolution. In this review, we aimed to update the surgical management of pulmonary metastases as well as systemic the...

Descripción completa

Detalles Bibliográficos
Autores principales: Seitlinger, Joseph, Prieto, Mathilde, Siat, Joelle, Renaud, Stéphane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107562/
https://www.ncbi.nlm.nih.gov/pubmed/34012612
http://dx.doi.org/10.21037/jtd-2019-pm-10
_version_ 1783689980129837056
author Seitlinger, Joseph
Prieto, Mathilde
Siat, Joelle
Renaud, Stéphane
author_facet Seitlinger, Joseph
Prieto, Mathilde
Siat, Joelle
Renaud, Stéphane
author_sort Seitlinger, Joseph
collection PubMed
description Renal cell carcinoma (RCC) remains a public health issue and seems to be increasing. A significant proportion of RCC patients will develop pulmonary metastasis at some point in their evolution. In this review, we aimed to update the surgical management of pulmonary metastases as well as systemic therapy, including targeted therapies, according to recent data in the literature. We retrospectively reviewed studies evaluating the benefit of pulmonary metastasectomy in RCC patients and evaluating the place of different chemotherapies, targeted therapies and immunotherapies through November 1, 2019. Several retrospective studies have shown the benefit of pulmonary metastasectomy in metastatic RCC (mRCC), most in a situation with only pulmonary metastases. According to the prognostic criteria of the IMDC risk model, the patient is classified into a prognostic group to identify the best systemic treatment. With the development of targeted therapies, the modalities are multiple and may involve tyrosine kinase inhibitors/checkpoint inhibitors and soon vaccine therapy or CAR-T cells. At the local level, in patients who cannot benefit from surgery, stereotactic radiotherapy or radiofrequency has a place to be considered. Although there is a lack of a randomized study, pulmonary metastasectomy appears to be feasible and effective. The place and modalities of systemic therapies in the era of targeted therapies remain to be more clearly defined.
format Online
Article
Text
id pubmed-8107562
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-81075622021-05-18 Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment Seitlinger, Joseph Prieto, Mathilde Siat, Joelle Renaud, Stéphane J Thorac Dis Review Article on Pulmonary Metastases Renal cell carcinoma (RCC) remains a public health issue and seems to be increasing. A significant proportion of RCC patients will develop pulmonary metastasis at some point in their evolution. In this review, we aimed to update the surgical management of pulmonary metastases as well as systemic therapy, including targeted therapies, according to recent data in the literature. We retrospectively reviewed studies evaluating the benefit of pulmonary metastasectomy in RCC patients and evaluating the place of different chemotherapies, targeted therapies and immunotherapies through November 1, 2019. Several retrospective studies have shown the benefit of pulmonary metastasectomy in metastatic RCC (mRCC), most in a situation with only pulmonary metastases. According to the prognostic criteria of the IMDC risk model, the patient is classified into a prognostic group to identify the best systemic treatment. With the development of targeted therapies, the modalities are multiple and may involve tyrosine kinase inhibitors/checkpoint inhibitors and soon vaccine therapy or CAR-T cells. At the local level, in patients who cannot benefit from surgery, stereotactic radiotherapy or radiofrequency has a place to be considered. Although there is a lack of a randomized study, pulmonary metastasectomy appears to be feasible and effective. The place and modalities of systemic therapies in the era of targeted therapies remain to be more clearly defined. AME Publishing Company 2021-04 /pmc/articles/PMC8107562/ /pubmed/34012612 http://dx.doi.org/10.21037/jtd-2019-pm-10 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Pulmonary Metastases
Seitlinger, Joseph
Prieto, Mathilde
Siat, Joelle
Renaud, Stéphane
Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
title Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
title_full Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
title_fullStr Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
title_full_unstemmed Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
title_short Pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
title_sort pulmonary metastasectomy in renal cell carcinoma: a mainstay of multidisciplinary treatment
topic Review Article on Pulmonary Metastases
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107562/
https://www.ncbi.nlm.nih.gov/pubmed/34012612
http://dx.doi.org/10.21037/jtd-2019-pm-10
work_keys_str_mv AT seitlingerjoseph pulmonarymetastasectomyinrenalcellcarcinomaamainstayofmultidisciplinarytreatment
AT prietomathilde pulmonarymetastasectomyinrenalcellcarcinomaamainstayofmultidisciplinarytreatment
AT siatjoelle pulmonarymetastasectomyinrenalcellcarcinomaamainstayofmultidisciplinarytreatment
AT renaudstephane pulmonarymetastasectomyinrenalcellcarcinomaamainstayofmultidisciplinarytreatment