Pulmonary Metastasectomy after Immune Checkpoint Inhibitors in Renal Cell Carcinoma

The management of oligometastatic renal cell carcinoma with pulmonary metastases is controversial and occasionally requires multimodality management, including salvage pulmonary metastasectomy after immune checkpoint inhibitors (ICIs). However, limited data are available on these patients. We describe a case series of three consecutive patients who underwent salvage pulmonary metastasectomy after ICIs for oligometastatic renal cell carcinoma and discussed the important characteristics of these patients. After salvage pulmonary metastasectomy, none of the patients had recurrent pulmonary metastases, although one of them developed a brain metastasis postoperatively. Our case series suggests that salvage pulmonary metastasectomy after ICIs may control pulmonary metastases in carefully selected patients with oligometastatic renal cell carcinoma, although the management of extrapulmonary metastases may be required after salvage pulmonary metastasectomy.