The role of surgery in the management of patients with metastatic renal cell cancer to the lung is controversial. Physicians in Germany evaluated the results of surgery in 77 patients with lung metastasis from renal cell cancer and no evidence of cancer elsewhere in the body, including the primary kidney site.

Three percent of patients died from complications of surgical removal of cancer in the lungs. Thirty-nine per cent of patients survived 5 years from surgery with an average follow-up of 34 months. Patients with a single site of cancer in the lung had a 49% survival compared to 19% for patients with more than one site removed from the lung.

These physicians concluded that surgical resection should be performed in patients who only have cancer spread to the lung since renal cell carcinomas are almost always resistant to chemotherapy, radiation therapy and immunotherapy. Furthermore, surgery should be performed in patients who have a partial response to chemotherapy or immunotherapy in order to produce a complete response. (Anticancer Research; Vol 19, No 2C, pp 1593-1596, 1999)

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