The Impact of Local Intervention Combined with Targeted Therapy on Metastatic Renal Cell Carcinoma

Background/Aim: We performed a retrospective survey on our metastatic renal cell carcinoma (MRCC) patients who had received targeted therapies, and afterwards evaluated the clinical impacts of local interventions on the patient outcomes. Materials and Methods: Between 2006 and 2016, 124 patients with MRCC who had received at least one line of tyrosine kinase inhibitors or mammalian target of rapamycin were included in the study. Seventy-five patients (60.5%) received targeted therapies only, twenty-six patients received complete resection and the remaining 23 received incomplete local interventions for their metastatic lesions. Analysis of the basic characteristics, overall survival and multi-variant regression amongst the three groups was performed. Results: The age, gender distribution, tumor cell type, targeted therapy selection, line of therapies and sites of metastases were not different amongst the three groups. The targeted therapy-only group had a significantly higher percentage of Memorial Sloan Kettering Cancer Center (MSKCC) poor-risk patients compared with the other two groups (22.7% vs. 3.8% and 0%, p=0.006 respectively). The targeted treatment duration and follow-up duration was significantly shorted in the targeted therapy-only group. Of the twelve variables analyzed, complete resection and MSKCC poor-risk group showed a significant impact on the overall survival rate (HR=0.5, 95%CI=0.25-0.98, p=0.045; HR=2.97, 95%CI=1.05-8.4, p=0.04 respectively). Conclusion: Complete resection of metastatic sites for MRCC patients, combined with targeted therapy, could provide better overall survival rates than targeted therapy alone. Poor MSKCC risk is still correlated to a poor outcome in the current targeted therapy era.

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