Cytoreductive Nephrectomy in Select Primary Metastatic Renal Cell Carcinoma Patients: A Comprehensive Nationwide Outcome Analysis
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Cytoreductive Nephrectomy in Select Primary Metastatic Renal Cell Carcinoma Patients : A Comprehensive Nationwide Outcome Analysis. / Azawi, Nessn; Geertsen, Louise; Nadler, Naomi; Mosholt, Karina Sif Soendergaard; Axelsen, Sofie Staal; Christensen, Jane; Jensen, Niels Viggo; Fristrup, Niels; Dalton, Susanne Oksbjerg; Donskov, Frede; Lund, Lars.
In: Cancers, Vol. 16, No. 6, 1132, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cytoreductive Nephrectomy in Select Primary Metastatic Renal Cell Carcinoma Patients
T2 - A Comprehensive Nationwide Outcome Analysis
AU - Azawi, Nessn
AU - Geertsen, Louise
AU - Nadler, Naomi
AU - Mosholt, Karina Sif Soendergaard
AU - Axelsen, Sofie Staal
AU - Christensen, Jane
AU - Jensen, Niels Viggo
AU - Fristrup, Niels
AU - Dalton, Susanne Oksbjerg
AU - Donskov, Frede
AU - Lund, Lars
N1 - Publisher Copyright: © 2024 by the authors.
PY - 2024
Y1 - 2024
N2 - (1) Background: The role of cytoreductive nephrectomy (CN) is controversial in patients with primary metastatic renal cell carcinoma (mRCC). (2) Methods: We evaluated the impact of CN, or no CN, followed by first-line targeted therapy (TT) in a nationwide unselected cohort of 437 consecutive patients with primary mRCC over a two-year period with a minimum of five years of follow-up. Data sources were national registries supplemented with manually extracted information from individual patient medical records. Cox proportional hazards estimated the hazard ratio (HR) of overall death and cancer-specific death after one and three years. (3) Results: 210 patients underwent CN and 227 did not. A total of 176 patients (40%) had CN followed by TT, 160 (37%) had TT alone, 34 (8%) underwent CN followed by observation, and 67 (15%) received no treatment. After adjustments in Model 2, patients treated with TT alone demonstrated a worsened overall survival (OS) compared to those treated with CN + TT, HR 0.63 (95% CI: 0.19–2.04). (4) Conclusions: In this nationwide study, CN was associated with enhanced outcomes in carefully selected patients with primary mRCC. Further randomized trials are warranted.
AB - (1) Background: The role of cytoreductive nephrectomy (CN) is controversial in patients with primary metastatic renal cell carcinoma (mRCC). (2) Methods: We evaluated the impact of CN, or no CN, followed by first-line targeted therapy (TT) in a nationwide unselected cohort of 437 consecutive patients with primary mRCC over a two-year period with a minimum of five years of follow-up. Data sources were national registries supplemented with manually extracted information from individual patient medical records. Cox proportional hazards estimated the hazard ratio (HR) of overall death and cancer-specific death after one and three years. (3) Results: 210 patients underwent CN and 227 did not. A total of 176 patients (40%) had CN followed by TT, 160 (37%) had TT alone, 34 (8%) underwent CN followed by observation, and 67 (15%) received no treatment. After adjustments in Model 2, patients treated with TT alone demonstrated a worsened overall survival (OS) compared to those treated with CN + TT, HR 0.63 (95% CI: 0.19–2.04). (4) Conclusions: In this nationwide study, CN was associated with enhanced outcomes in carefully selected patients with primary mRCC. Further randomized trials are warranted.
KW - cytoreductive nephrectomy
KW - real world data
KW - renal cell carcinoma
U2 - 10.3390/cancers16061132
DO - 10.3390/cancers16061132
M3 - Journal article
C2 - 38539467
AN - SCOPUS:85188686400
VL - 16
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 6
M1 - 1132
ER -
ID: 387254618