Resection of Pulmonary Metastasis in Clear Cell Renal Cell Carcinoma +/-Adjuvant Sunitinib Therapy (SMAT)

Exclusion Criteria

• •Presence of other metastases outside the lung
• •progress in the 12-week sunitinib therapy before resection of metastases
• •R1 or R2-finding in resection of metastases
• •Dialysis after nephrectomy
• •Previous or existing serious cardiovascular (grade III - IV according to NYHA(New York Heart Association)) disease, active angina pectoris or ischemia, myocardial infarction within previous 6 months , uncontrolled hypertension(RR diastolic 120 mmHg(Millimeters of mercury))
• •serious hematopoetic (e.g. serious Bone marrow aplasia), pulmonary, hepatic or renal Disease
• •Stroke within the previous six months
• •Patients with poorly controlled diabetes mellitus
• •Serious bacterial or fungal infections
• •chronic hepatitis B or C, HIV(human immunodeficiency virus) infection
• •autoimmune disease
• •prior organ transplantation
• •prior autologous bone marrow transplant or stem cell transferred within the last 4 months before study
• •Neuropsychiatric diseases that affect patient compliance
• •Manifesto, second malignancy or other malignancy within the past 5 years (except basal cell carcinoma, carcinoma in situ of the cervix, incidental prostate carcinoma, superficial urothelial Ca pTaG1-2 and pT1G1)
• •Therapy with immunotherapeutic agents including monoclonal antibodies, cytotoxic drugs or hormones (other than bisphosphonates and oral contraceptives) within the last 4 weeks prior to enrollment. Previous use of inhibitors of Ras/Raf-, MEK kinase, AKT kinase and mTOR inhibitors or induction of Farnesyltransferase
• •Previous use of angiogenesis inhibitors such as VEGF / VEGFR, PDGF / PDGFR and other key molecules of angiogenesis
• •parallel treatment with rifampicin
• •Participation in other treatment studies in the last 4 weeks