Surgical resection for management of renal cancer with hepatic involvement.

Abstract

More than 900 patients who underwent hepatic resections were reviewed to identify those whose liver resections were due to involvement by renal cell carcinoma. Three patients with direct hepatic extension of the renal cell cancer underwent radical nephrectomy with en bloc partial hepatectomy, while 1 with a metachronous recurrence 3 years after nephrectomy underwent right triple lobe hepatectomy. There were no postoperative complications. Of the en bloc resections 2 showed sarcomatoid features on histopathological examination. These patients experienced rapid disease progression and died. The remaining 2 patients with typical clear cell carcinoma have no evidence of disease. Experience with these 4 patients has demonstrated that hepatic resection is technically feasible and associated with acceptable morbidity rates. Surgical management should be considered in patients with the uncommon presentation of renal cell carcinoma and localized hepatic involvement.