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Regression of metastatic renal cell carcinoma after cytoreductive nephrectomy
S G Marcus1, P L Choyke, R Reiter
1Surgery Branch, National Cancer Institute, Bethesda, Maryland.
Abstract:
Fewer than 1% of patients with renal cell carcinoma are reported to experience spontaneous regression of metastatic lesions after nephrectomy. We report on 4 of 91 patients (4.4%) with metastatic renal cell carcinoma who had spontaneous regression of all metastatic lesions after cytoreductive nephrectomy. These patients were carefully selected before surgery for the ability to receive high dose interleukin-2. One patient had recurrence at 2 months, 1 had recurrence at 11 months, and 2 had no evidence of disease at 3 and 4.5 years.
Insights
Spontaneous regression of metastatic renal cell carcinoma is rare. However, 4.4% of selected patients experienced regression after cytoreductive nephrectomy, with two remaining disease-free for years.
Area of Science:
- Oncology
- Immunotherapy
Background:
- Metastatic renal cell carcinoma (mRCC) has a poor prognosis.
- Spontaneous regression of metastatic lesions post-nephrectomy is exceptionally rare, reported in less than 1% of cases.
Observation:
- This study reports on 91 patients with mRCC undergoing cytoreductive nephrectomy.
- Four patients (4.4%) exhibited spontaneous regression of all metastatic lesions post-surgery.
Findings:
- Patients were pre-selected for high-dose interleukin-2 (IL-2) therapy.
- One patient recurred at 2 months, another at 11 months.
- Two patients remained with no evidence of disease at 3 and 4.5 years post-treatment.
Implications:
- Cytoreductive nephrectomy in carefully selected mRCC patients may enhance the potential for spontaneous regression.
- Further research into patient selection criteria for immunotherapy post-nephrectomy is warranted.
- High-dose IL-2 may play a role in achieving durable responses in select mRCC patients.