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Impact of Surgical Resection of Metastases Refractory to Systemic Therapy on Survival and Quality of Life – a Phase II Trial

Objective: We initiated a prospective phase II trial to assess the outcome of complete surgical removal of metastases from different tumor entities (renal cell cancer n = 32, bladder cancer n = 45, prostate cancer n = 13, and penile cancer n = 2) with regard to survival and quality of life. Patients and Methods: 92 patients with asymptomatic (n = 21) and symptomatic (n = 71) secondaries from genitourinary cancers (testicular cancer were excluded) refractory to systemic therapy were included. We removed secondaries metastatic to lymph nodes, peritoneum, skin, adrenals, bone, lung, and liver and measured survival and performance score. Results: With a 1-year survival rate of 36% prognosis is unfavorable independent from histopathology and site of metastasis, revealing no benefit regarding survival. However, 83% of the patients with symptomatic secondaries did benefit from surgery regarding quality of life, i.e. performance score. Conclusion: Surgical removal of metastases from genitourinary cancers refractory of systemic therapy has an impact on quality of life limited to patients with symptomatic disease.