Approximately 20% of patients with kidney cancer will have metastatic disease at the time of their initial diagnosis, and 30% to 40% of patients develop metastasis after nephrectomy or resection. Treatment of these patients remains challenging, and data on the best course of action is lacking, says Viraj Master, MD, of Emory University in Atlanta.
In this video, Dr. Master offers the latest evidence and his recommendations for managing synchronous and metachronous disease in the face of renal cell carcinoma, including the role of metastasectomy. He highlights the importance of a multidisciplinary approach.
“Regretfully, in spite of the fact that so many patients experience [metastases], there’s a real lack of data in this space. If you have a patient that has relatively few spots of disease and you think with whatever procedure is in your arsenal you can remove all disease, that’s the best patient to do it on,” Dr. Master said.
“Let’s say that patient has three different lung spots. If you can get those out [surgically], or radiate those spots, or use cryotherapy to ablate those spots, that patient is going to do well and may not ever require going on to systemic therapy, perhaps for years, perhaps months, but perhaps ever.”
The weight of the evidence in the literature supports surgery as the preferred modality to remove metastases, he said.