Metastasis-directed therapy in oligometastatic and oligoprogressive renal cell carcinoma.

Abstract

Purpose of review: This review addresses the evolving role of metastasis-directed therapy (MDT) in the management of oligometastatic and oligoprogressive renal cell carcinoma (RCC). With advances in both surgical techniques and stereotactic ablative radiotherapy (SABR), it is timely to explore how MDT can improve patient outcomes in these distinct disease states. The review highlights the potential of MDT to delay systemic therapy and improve quality of life while noting the lack of randomized clinical trial data guiding its use.

Recent findings: Recent literature emphasizes the outcomes of MDT, including metastasectomy and SABR, in managing oligometastatic and oligoprogressive RCC. Key studies suggest that MDT may prolong progression-free survival and delay systemic therapy. SABR has demonstrated high local control rates and manageable toxicity, offering a less invasive alternative to surgery. Despite these findings, there remains uncertainty about MDT's long-term impact on overall survival due to the absence of prospective randomized trials.

Summary: MDT holds promise in treating RCC by offering symptom relief, improving quality of life, and potentially delaying systemic therapy. However, the long-term benefits, particularly regarding survival outcomes, remain unclear. Further research, including prospective trials, is needed to better define the role of MDT in clinical practice, particularly in the absence of clear guidelines for patient selection.