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Der Urologe

, Volume 51, Issue 9, pp 1202–1208 | Cite as

Metastasenresektion beim Nierenzellkarzinom

  • B. Brehmer
  • C. Piper
  • D. Pfister
  • D. Porres
  • A. Heidenreich
Übersichten

Zusammenfassung

Hintergrund

Die Metastasenresektion wird vor oder nach einer systemischen Therapie im Rahmen eines multimodalen Therapiekonzepts beim metastasierten Nierenzellkarzinom (mNZK) durchgeführt. Unter welchen Voraussetzungen die Prognose durch diese Resektion verbessert wird, wird kontrovers diskutiert. Ziel dieser Arbeit ist es, die publizierten Daten diesbezüglich zu sichten und kritisch zusammenzufassen.

Methode

Es wurde eine systematische MedLine-Recherche bezüglich Metastasenresektion bei mNZK durchgeführt. Original publizierte Daten, Reviews und Editorials wurden in diese Übersicht einbezogen. Weiterhin wurden die aktuellen Europäischen Guidelines berücksichtigt.

Ergebnisse

Eine Resektion von Metastasen beim mNZK sollte durchgeführt werden, wenn eine stabile Erkrankung mindestens über 3 Monate vorliegt, eine komplette Resektion möglich ist und ein guter Performancestatus des Patienten vorliegt. Die mittlere Überlebenszeit reicht nach Resektion von 35–55 Monate.

Schlussfolgerung

Beim mNZK ist die Metastasenresektion eine Therapieoption die bei günstigen Prognosefaktoren das mittlere Überleben verlängern kann. Die Metastasenresektion sollte einen festen Stellenwert für geeignete Patienten in der multimodalen Therapie haben.

Schlüsselwörter

Metastasenresektion Nierenzellkarzinom Therapie, neoadjuvante Tyrosinkinaseinhibitoren 

Metastasectomy for renal cell cancer

Abstract

Background

Metastasectomy prior to or after systemic medical cancer treatment is performed within a multimodal therapeutic approach in metastatic renal cell cancer (mRCC) to improve the prognosis. The role of metastasectomy in mRCC is controversially discussed and the potential therapeutic benefit is unquantifiable. The purpose of the current review is to critically discuss the available data.

Methods

A systematic literature search was carried out in the MedLinedatabase to identify original publications, review articles and editorials with respect to metastasectomy in mRCC and the current European guidelines were also taken into consideration.

Results

Metastasectomy is one of the approaches for mRCC recommended in the guidelines in cases of stable disease for at least 3 months, complete resectability of all metastatic lesions independent of the anatomic localization and a good performance status of the patient. The median survival time varies between 35 and 55 months.

Conclusions

In mRCC metastasectomy is an indiviudal therapeutic approach which might be considered for limited metastatic disease and the presence of good prognostic risk factors to improve average survival time. Especially in renal cell cancer metastasectomy should be considered early.

Keywords

Metastasectomy Renal cell carcinoma Targeted therapy, neoadjuvant Tyrosine kinase inhibitors 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • B. Brehmer
    • 1
  • C. Piper
    • 1
  • D. Pfister
    • 1
  • D. Porres
    • 1
  • A. Heidenreich
    • 1
  1. 1.Klinik für UrologieUniversitätsklinikum der RWTH AachenAachenDeutschland

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