Survival of patients undergoing cytoreductive surgery for metastatic renal cell carcinoma in the targeted-therapy era

Abstract

Background/aim: In the cytokine era, cytoreductive nephrectomy (CN) improves survival for patients with metastatic renal cell carcinoma (mRCC). We analyzed the effect of CN on the survival of patients diagnosed with mRCC in the era of tyrosine kinase inhibitors (2005-present).

Patients and methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify adult patients diagnosed with mRCC between 2005 and 2009. The primary outcome was overall survival, analyzed with multivariable Cox models.

Results: Out of 7,143 incident mRCC cases reported to SEER between 2005-2009, 2,629 (37%) underwent CN. Patients undergoing CN were younger, and more likely to be white, male, and married. Patients with stage T3 tumors were most likely to undergo CN (64%). Patients that underwent CN had improved one-year survival (61% vs. 22%). On multivariable analysis, CN was associated with improved overall survival(hazard ratio[HR]=0.40 95% confidence interval [CI]=0.37-0.43).

Conclusion: In the targeted-therapy era, patients with mRCC undergoing CN have improved survival after adjusting for tumor stage and demographic characteristics.

Keywords: Renal cell carcinoma; cytoreductive nephrectomy; targeted therapy; tyrosine kinase inhibitor.