Stellenwert der Lungenmetastasenchirurgie beim metastasierenden Nierenzellkarzinom

The clinical value of pulmonary resection for metastatic renal carcinoma has been documented. In selected patients, 5- and 10-year survival rates vary between 35-45% and 10-30%, respectively. As expected in solid carcinomas, curative resection of the lesions is the most significant factor for long-term survival. Furthermore, the number of lesions, size, and malignant lymphatic involvement are considered to be of prognostic influence. The importance of the disease-free interval is still under discussion. The use of minimally invasive procedures, e.g., video-assisted thoracoscopic surgery and radiofrequency ablation, does not provide sufficient curative resection. Manual palpation following thoracotomy allows detection of additional metastases in 30-60% of the patients. Thus, these minimal procedures are only permissible within controlled clinical studies.