Факторы прогноза хирургического лечения больных с метастазами рака почки в легких

The paper reviews Russian and foreign references on the choice of treatment policy in patients with renal cancer metastases to the lung providing that primary kidney tumor can be removed or that there is a history of nephrectomy and there are no metastases in other organs. It describes the results of surgical and medical treatment (immunotherapy) in this category of patients. Particular emphasis is placed on the importance of prognostic factors when choosing treatment policy. Key prognostic factors, such as the possibility of complete removal of lung metastases, the number and sizes of foci, and a postnephrectomy disease-free interval (DFI), are identified. Four prognostic groups are made up and the long-term results of surgical treatment are given in the patients of each group. The general conclusion can be drawn regarding that drug therapy should be preferred over surgical treatment when metastases are irresectable or there is a combination of some poorfactors (more than 6 foci, a short metastasis-free interval of < 36 months or DFI = 0).