[Metastasectomy in XXXX after neoadjuvant therapy with multi- @entity669 kinase inhibitors].

@entity1 @entity13850 @entity788 @entity66 @entity2240 @entity39 @entity4438 @entity189 @entity1358 @entity3 @entity669 @entity3027 @entity703
BACKGROUND: @entity1358 ( @entity1358 ) still poses a challenge to therapists in spite of the availability of multiple innovative molecular treatment options. Complete remission is rare and in cases of partial remission it is often unclear if @entity39 or vital @entity189 tissue persists. We report on a cohort of @entity1 who underwent metastasectomy after neoadjuvant therapy with multi- @entity669 kinase inhibitors (MTKI). METHODS: In 2009 a total of 11 @entity1 (7 male and 4 female) underwent metastasectomy after achievement of >=  3 months stable partial remission. All @entity1 received either @entity2240 (n=7, mean 5.5 cycles), bevacizumab and interferon ( @entity3027 )-a2a (n=2, mean 8.5 months), @entity13850 (n=1, mean 9 months) or a combination of @entity2240 followed by @entity13850 (n=1). Of the @entity1 7 presented with retroperitoneal lymph node @entity3 with a mean diameter of 3.5-12 cm, 2 @entity1 with pulmonary @entity3 , 1 @entity1 with lymph node and pancreas tail @entity3 and 1 female @entity1 showed @entity66 in the vena cava. RESULTS: All @entity3 were completely resected with negative surgical margins. In 82% of the cases histologically active, Ki-67 positive @entity1358 tissue was identified. The following adjunctive interventions were necessary: vena cava resection with vascular prosthesis and reimplantation of the renal vein (n=3), partial liver resection (n=1), splenectomy (n=1) and pancreas tail resection (n=1). There were no significant perioperative complications but 1 @entity1 developed @entity4438 dehiscence and underwent revision surgery and 1 @entity1 developed clinically insignificant @entity788 . After a median follow-up of 12 months (range 8-19 months) 5 @entity1 had no recurrence and 6 of the @entity1 showed liver (n=3), lung (n=2) or bone (n=1) recurrences from which 3 @entity1 died. CONCLUSIONS: Metastasectomy of @entity1358 is associated with a low rate of complications in experienced centers. Surgical resection of metastatic disease is indicated to achieve complete remission with a favorable prognosis because of biologically active @entity703 tissue. @entity1 with isolated and resectable @entity3 are ideal candidates for such a procedure.
