Lung metastases of renal cell carcinoma: results of surgical resection

OBJECTIVE: The research was designed to evaluate the results of surgicalresection of renal lung metastases. METHODS: Between 1960 and 1994, 50consecutive patients underwent resection for pulmonary metastases fromrenal cell carcinoma. Mean age was 59 years (range: 40- 78 years). Meantime between nephrectomy and pulmonary resection was 3 years (range: 0-18years). Nineteen patients had solitary metastase, 13 multiple unilateral,and 18 bilateral. Wedge excision was performed in 28 patients,segmentectomy in 3, lobectomy in 17, sleeve lobectomy in 1, pneumonectomyin 5 and biopsy in 3. Twelve patients had repeat resection for recurrentmetastases. RESULTS: The resection was complete in 45 patients. Threepatients also had a complete resection of limited extra-pulmonary disease.There was one postoperative death and 3 complications. Mean follow-up was42 months without loss of follow-up. The cause of death was alwaysmetastatic recurrent disease. Five-year survival in complete resection was44%. Only one long survivor was observed in the case of incompleteresection in a patient who had a complete response after adjuvantimmunotherapy. Five-year survival for the 12 patients with repeatresections was similar to the overall survival rate (42%). CONCLUSIONS:Resection of renal lung metastases is a safe and effective treatment. Nofactor influenced the 5-year survival in this series except the completeresection. Extra-pulmonary metastases does not contra-indicate pulmonaryresection. In selected patients, repeat resection for recurrent disease iswarranted.