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. 2020 Oct 10;12(10):2911.
doi: 10.3390/cancers12102911.

Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy-Data from the National Renis Registry

Alexandr Poprach  1   2 , Milos Holanek  1   2 , Renata Chloupkova  3 , Radek Lakomy  1   2 , Michal Stanik  4 , Ondrej Fiala  5 , Bohuslav Melichar  6   7 , Katerina Kopeckova  8 , Milada Zemanova  9 , Igor Kiss  1   2 , Igor Penka  10 , Julia Bohosova  11 , Tomas Buchler  12
Affiliations

Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy-Data from the National Renis Registry

Alexandr Poprach et al. Cancers (Basel). .

Abstract

The role of cytoreductive nephrectomy (CN) in treatment of locally advanced or metastatic renal cell carcinoma (mRCC) in the era of targeted therapies (TT) is still not clearly defined. The study population consisted of 730 patients with synchronous mRCC. The RenIS (Renal carcinoma Information System) registry was used as the data source. The CN/TT cohort included patients having CN within 3 months from the mRCC diagnosis and subsequently being treated with TT, while the TT cohort included patients receiving TT upfront. Median progression-free survival from the first intervention was 6.7 months in the TT arm and 9.3 months in the CN/TT patients (p < 0.001). Median overall survival was 14.2 and 27.2 months, respectively (p < 0.001). Liver metastasis, high-grade tumor, absence of CN, non-clear cell histology, and MSKCC (Memorial Sloan-Kettering Cancer Center) poor prognosis status were associated with adverse treatment outcomes. According to the results of this retrospective study, patients who underwent CN and subsequently were treated with TT had better outcomes compared to patients treated with upfront TT. The results of the study support the use of CN in the treatment algorithm for mRCC.

Keywords: cytoreductive nephrectomy; metastatic renal cell carcinoma; overall survival; targeted therapy.

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Conflict of interest statement

A.P. received honoraria and research support from Roche, Bristol Myers Squibb, Novartis, Pfizer, and Ipsen unrelated to this project. T.B. received honoraria and research support from Novartis, Pfizer, Roche, Bristol Myers Squibb, and Ipsen. O.F. received honoraria from Roche, Janssen, Glaxo Smith Kline, and Pfizer for consultations and lectures. B.M. received honoraria for speeches and advisory role Roche, Pfizer, BMS, Astellas, Novartis, Bayer, MSD, Merck Serono, Sanofi, Servier, AstraZeneca, Amgen, Janssen, Eisai, E. Lilly, and Pierre Fabre. M.Z. received honoraria and research support from Novartis, Pfizer, Bristol Myers Squibb, MSD, and AstraZeneca. I.K. has received speakers’ honoraria from Roche, Merck, and Amgen. Other authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Progression-free (A) and overall survival (B) from first treatment strategy. All the differences were statistically significant at p < 0.001.
See this image and copyright information in PMC

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