Utilization of Partial Cytoreductive Nephrectomy in Patients with Metastatic Renal Cell Carcinoma

被引:1
作者
Hauser, Nicholas [1 ]
Giakas, Julian [1 ]
Robinson, Hunter [2 ]
Davaro, Facundo [3 ]
Hamilton, Zachary [4 ]
机构
[1] St Louis Univ, Sch Med, 1402 S Grand Blvd, St Louis, MO 63104 USA
[2] Geisinger Med Ctr, 100 N Acad Ave, Danville, PA 17822 USA
[3] H Lee Moffitt Canc Ctr & Res Inst, 1600 SW Archer Rd, Gainesville, FL 32608 USA
[4] SSM Hlth St Louis Univ Hosp, Div Urol, 1225 S Grand Blvd, St Louis, MO 63104 USA
关键词
partial cytoreductive nephrectomy; metastatic renal cell carcinoma; perioperative outcomes; cytoreductive nephrectomy; MANAGEMENT; SURVIVAL; SURGERY; DISEASE; CANCER;
D O I
10.3390/jcm13195767
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: Cytoreductive nephrectomy for metastatic renal cell carcinoma (mRCC) is a standard of care. Partial nephrectomy (PN) in the setting of metastatic disease is an uncommon occurrence, and we aimed to characterize its utilization in a modern cohort. Methods: The National Cancer Database was reviewed for patients with mRCC from 2010 to 2017. Patients with cTanyNanyM1 who underwent cytoreductive surgery in the form of PN or radical nephrectomy (RN) were compiled. Our primary outcome was survival outcome for patients who underwent PN compared to RN. Secondary outcomes included 30-day readmission, length of stay, and survival outcomes. Results obtained: A total of 13,896 patients with mRCC who underwent cytoreductive surgery were identified. In total, 13,242 underwent RN and 654 underwent PN. The RN population was more likely to have cN positive disease, while the PN population was more likely to have cT1 disease. Length of stay, readmission and 30-day mortality were not significantly different between PN and RN, but overall mortality and 90-day mortality favored PN (p < 0.001). Cox regression for death showed PN with improved overall survival (HR 0.782, p < 0.001). Logistic regression for predictors of cytoreductive PN revealed cT1 and cN0 as significant factors. Overall survival, as seen on KM analysis, identified that PN exhibited improved 2-year (67.1% vs. 52.0%) and 5-year (40.7% vs. 29.2%) overall survival relative to RN (p < 0.001). Conclusions: PN is an infrequent treatment with mRCC and its utilization is stable from 2010 to 2017. Overall survival is significantly better for those undergoing PN, likely due to their favorable oncologic disease characteristics.
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页数:12
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