TY - JOUR
T1 - The role of metastasectomy in advanced renal cell carcinoma
AU - Apollonio, Giulia
AU - Raimondi, Alessandra
AU - Verzoni, Elena
AU - Claps, Melanie
AU - Sepe, Pierangela
AU - Pagani, Filippo
AU - Ratta, Raffaele
AU - Montorsi, Francesco
AU - De Braud, Filippo Guglielmo Maria
AU - Procopio, Giuseppe
PY - 2019/7/3
Y1 - 2019/7/3
N2 - Introduction: So far, clinical experiences have proved metastasectomy as the only approach in the setting of metastatic renal cell carcinoma that may achieve the ‘no evidence of disease’ status, with an associated improvement in survival. Areas covered: This review aims to summarize the body of knowledge on therapeutic approaches to mRCC, with a specific insight on the role of metastasectomy and on which underlying factors could be good predictors to select patients who may benefit from surgery. In detail, we managed to identify as potential selection criteria: the number of lesions and their site, the DFI, patients’ performance status and, most of all, the completeness of resection. Expert opinion: The definition of the optimal treatment strategy of mRCC patients is still an unmet clinical need. The decision-making process about treatment strategy should consider specific tumor’s and patient’s characteristics, as well as the integration of the available therapeutic approaches with the aim to reach the best clinical outcome. We consider multidisciplinary management mandatory in order to tailor the treatment approach according to the patient and disease features. The experience of clinicians may be considered crucial in order to select the best candidates for a multimodal approach.
AB - Introduction: So far, clinical experiences have proved metastasectomy as the only approach in the setting of metastatic renal cell carcinoma that may achieve the ‘no evidence of disease’ status, with an associated improvement in survival. Areas covered: This review aims to summarize the body of knowledge on therapeutic approaches to mRCC, with a specific insight on the role of metastasectomy and on which underlying factors could be good predictors to select patients who may benefit from surgery. In detail, we managed to identify as potential selection criteria: the number of lesions and their site, the DFI, patients’ performance status and, most of all, the completeness of resection. Expert opinion: The definition of the optimal treatment strategy of mRCC patients is still an unmet clinical need. The decision-making process about treatment strategy should consider specific tumor’s and patient’s characteristics, as well as the integration of the available therapeutic approaches with the aim to reach the best clinical outcome. We consider multidisciplinary management mandatory in order to tailor the treatment approach according to the patient and disease features. The experience of clinicians may be considered crucial in order to select the best candidates for a multimodal approach.
KW - immunotherapy
KW - Metastasectomy
KW - renal cell carcinoma
KW - surgical approach
KW - targeted therapies
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U2 - 10.1080/14737140.2019.1625772
DO - 10.1080/14737140.2019.1625772
M3 - Review article
C2 - 31159619
AN - SCOPUS:85069518474
VL - 19
SP - 603
EP - 611
JO - Expert Review of Anticancer Therapy
JF - Expert Review of Anticancer Therapy
SN - 1473-7140
IS - 7
ER -