The Necessity of Cytoreductive Nephrectomy in Patients With Metastatic Renal Cell Carcinoma Using Antiangiogenic Targeted Therapy After Interferon Alfa-2b

The effects of cytoreductive nephrectomy (CRN) on prognosis of patients with metastatic renal cell cancer (RCC) using antiangiogenic targeted agents were evaluated. The median overall survival was significantly higher in the group that received CRN (P = .034). We speculate that CRN is still an important part of treatment modalities in patients with metastatic RCC in modern era targeted therapy, which is currently the best systemic therapy. Background: Targeted therapy has improved the survival of patients with metastatic RCC. In the present study, we evaluated whether there was an effect of cytoreductive surgery on prognosis of patients with metastatic RCC using antiangiogenic tyrosine kinase inhibitor (TKI) agents. Patients and Methods: A total of 52 patients with metastatic RCC from Akdeniz University, Afyon Kocatepe University, and Medipol University participated in the study. All the patients had received targeted antiangiogenic therapy after interferon alfa-2b. According to previous CRN, the patients were divided into 2 groups as CRN (+) and CRN (-). Results: The CRN (+) group was younger than the CRN (-) group (P < .001) and the hemoglobin levels were significantly higher in the CRN (+) group (P = .023). The median progression-free survival time from the date of starting TKIs were 8.5 and 3.0 months for the CRN (+) and CRN (-) groups, respectively (P = .104). The median overall survival was 15.1 and 5.4 months for the CRN (+) and CRN (-) groups, respectively (P = .034). Conclusion: We speculate that CRN is still an important part of treatment modalities in patients with metastatic RCC in modern era targeted therapy, which is currently the best systemic therapy. However, the indications of CRN might be limited to good-risk patients with metastatic RCC. Further randomized studies are warranted to clarify the necessity of CRN in patients with metastatic RCC. (C) 2014 Elsevier Inc. All rights reserved.