Local treatments for metastases of renal cell carcinoma

a systematic review

Saeed Dabestani, Lorenzo Marconi, Fabian Hofmann, Fiona Stewart, Thomas B L Lam, Steven E Canfield, Michael Staehler, Thomas Powles, Börje Ljungberg, Axel Bex

Research output: Contribution to journalArticle

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Abstract

Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefits and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the findings presented here should be interpreted with caution, they and the identified gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.

Original languageEnglish
Pages (from-to)e549-561
Number of pages13
JournalThe Lancet. Oncology
Volume15
Issue number12
Early online date26 Oct 2014
DOIs
Publication statusPublished - Nov 2014

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Metastasectomy
Renal Cell Carcinoma
Neoplasm Metastasis
Radiotherapy
Therapeutics
Research Personnel
Bone and Bones
Pain
Survival
Research

Keywords

  • Bone Neoplasms
  • Carcinoma, Renal Cell
  • Humans
  • Lung Neoplasms
  • Metastasectomy
  • Neoplasm Metastasis

Cite this

Dabestani, S., Marconi, L., Hofmann, F., Stewart, F., Lam, T. B. L., Canfield, S. E., ... Bex, A. (2014). Local treatments for metastases of renal cell carcinoma: a systematic review. The Lancet. Oncology, 15(12), e549-561. https://doi.org/10.1016/S1470-2045(14)70235-9

Local treatments for metastases of renal cell carcinoma : a systematic review. / Dabestani, Saeed; Marconi, Lorenzo; Hofmann, Fabian; Stewart, Fiona; Lam, Thomas B L; Canfield, Steven E; Staehler, Michael; Powles, Thomas; Ljungberg, Börje; Bex, Axel.

In: The Lancet. Oncology, Vol. 15, No. 12, 11.2014, p. e549-561.

Research output: Contribution to journalArticle

Dabestani, S, Marconi, L, Hofmann, F, Stewart, F, Lam, TBL, Canfield, SE, Staehler, M, Powles, T, Ljungberg, B & Bex, A 2014, 'Local treatments for metastases of renal cell carcinoma: a systematic review', The Lancet. Oncology, vol. 15, no. 12, pp. e549-561. https://doi.org/10.1016/S1470-2045(14)70235-9
Dabestani, Saeed ; Marconi, Lorenzo ; Hofmann, Fabian ; Stewart, Fiona ; Lam, Thomas B L ; Canfield, Steven E ; Staehler, Michael ; Powles, Thomas ; Ljungberg, Börje ; Bex, Axel. / Local treatments for metastases of renal cell carcinoma : a systematic review. In: The Lancet. Oncology. 2014 ; Vol. 15, No. 12. pp. e549-561.
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AU - Canfield, Steven E

AU - Staehler, Michael

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AB - Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefits and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the findings presented here should be interpreted with caution, they and the identified gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.

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