Editing Metastatic Kidney Cancer (section)

=== Metastatectomy for distant recurrence ===

* No randomized trials comparing metastatectomy to systemic treatments; most studies are retrospective in nature. However, among patients who develop metachronous metastases after nephrectomy, ≈1/3 are eligible for metastatectomy and studies report long-term survival for a subset of patients after complete resection of metastases
* '''Isolated metastases to the lung, thyroid, bone, pancreas, and adrenal glands have the most favourable prognosis'''.
** '''In most series, isolated pulmonary metastases were the lesions most commonly amenable to resection with curative intent'''
* Based on available observational data, patients most likely to benefit from metastatectomy are those
** Diagnosed with metastases over 2 years following nephrectomy
** With isolated metastases
** With favourable metastatic locations (lung, thyroid, bone, pancreas, adrenals).
* '''As per the 2019 CUA Management of Advanced Kidney Cancer Consensus Statement, in select patients with limited number of sites of metastatic disease and stable clinical condition, local therapy, such as resection and/or stereotactic body radiotherapy to treat of all sites of metastatic disease may be a reasonable option'''

'''Local therapy for oligoprogression'''

* '''As per the 2019 CUA Management of Advanced Kidney Cancer Consensus Statement, local therapy may be considered in the setting of oligoprogression'''

'''Role of radiation therapy in symptom control'''

* '''Radiation therapy may be considered to palliate symptoms from the primary tumor and metastases'''