Angioinfarction Plus Nephrectomy for Metastatic Renal Cell Carcinoma — An Update

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Abstract
Patients (100) with metastatic renal cell carcinoma were treated by angioinfarction of the primary tumor followed by radical nephrectomy; 88 of the patients also received postoperative parenteral progesterones. An overall response rate of 28% (complete regression of all metastatic lesions in 7 patients, regression > 50% in 8 and stabilization for at least 1 yr in 13) was achieved. Patients with parenchymal pulmonary metastases only had the best survival rate (64% at 1 yr) and are most likely to benefit from angioinfarction and nephrectomy. The presence of hilar or mediastinal adenopathy, pleural effusion or nonpulmaronary metastases confers a worse prognosis. These patients do not appear to survive longer with preoperative angioinfarction than if treated by nephrectomy alone. It is critically important to stratify patients by site and volume of disease when results are reported and compared for any patient undergoing treatment for metastatic renal cell carcinoma.