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Page 10 of 12 Feuer et al. J Cancer Metastasis Treat 2021;7:68 https://dx.doi.org/10.20517/2394-4722.2021.164

CONCLUSION
The role of metastasectomy in the era of immunotherapy remains underexplored and requires prospective
study to be fully ascertained. Initial evidence suggests that adjuvant systemic therapy, including
immunotherapy, may not improve outcomes. Nevertheless, the role of neoadjuvant systemic therapy has
not been elucidated, nor have all contemporary treatment options been explored.

Historically, retrospective evidence has demonstrated that metastasectomy may be a valuable management
option in the properly selected patient, dependent on factors related to (1) metastatic characteristics such as
the site, number of organs involved and number of metastases per site; (2) primary tumor factors such as
histologic grade, and stage; and (3) patient factors including age, and medical co-morbidities. Generally,
complete resection of solitary, single-organ metastases, with favorable primary tumor histology, in patients
with better performance status are associated with survival benefits after metastasectomy. Further, despite
the evolving landscape of therapeutic agents, metastasectomy remains the only means of a definitive cure
for mRCC. Nevertheless, it must be highlighted that a significant portion of the literature is retrospective in
nature and, as such, is limited by associated biases.

The decision to pursue metastasectomy should be considered within the framework of a multi-disciplinary
management discussion and, pending the results of future studies, may be a valuable tool in a multimodal
treatment approach.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: Feuer Z, Taylor J, Huang WC
Performed data acquisition, as well as provided administrative, technical, and material support: Feuer Z,
Taylor J, Huang WC

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2021.

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