Abstract
Introduction
The introduction of tyrosine kinase inhibitors has revolutionized treatment strategies
for metastatic renal cell carcinoma (RCC) and has improved survival rates. The number
of patients with bone metastases from RCC requiring surgery will increase as survival
rates improve. However, there is insufficient evidence to standardize the treatment
of bone metastases after the introduction of targeted therapy for metastatic RCC.
We aimed to determine the outcomes of palliative surgical treatment of bone metastases
in the extremities of patients with metastatic RCC.
Materials and methods
We retrospectively reviewed 26 lesions from 17 patients who underwent surgery for
extremity and acetabular bone metastases and were treated with targeted therapies
for advanced RCC between 2008 and 2020. The median follow-up duration was 19 months
(range, 4–76). We assessed the patients’ activities of daily living, quality of life,
and pain and analyzed their postoperative values relative to preoperative values.
Postoperative overall survival (OS), local progression-free survival (LPFS), and the
factors affecting them were evaluated using the Kaplan-Meier method and log-rank test.
Results
The 5-year OS and LPFS rates were 39.5% and 65.6%, respectively. The factors affecting
OS were sex, Katagiri score, visceral metastases, and preoperative targeted therapy,
while the factors affecting LPFS were pathologic fractures and surgical technique.
Conclusion
In this study, the postoperative outcomes of palliative surgery for bone metastases
from metastatic RCC were good. We suggest that systemic treatment should be prioritized
over local control for advanced bone metastasis in RCC and surgery before pathological
fracture should be performed for local control.
Keywords
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Article info
Publication history
Published online: November 25, 2022
Accepted:
November 14,
2022
Received in revised form:
November 8,
2022
Received:
May 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
