Cytoreductive Nephrectomy in Select Primary Metastatic Renal Cell Carcinoma Patients: A Comprehensive Nationwide Outcome Analysis

Nessn Azawi*, Louise Geertsen, Naomi Nadler, Karina Sif Soendergaard Mosholt, Sofie Staal Axelsen, Jane Christensen, Niels Viggo Jensen, Niels Fristrup, Susanne Oksbjerg Dalton, Frede Donskov, Lars Lund

*Corresponding author for this work

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Abstract

(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.

Original languageEnglish
Article number1132
JournalCancers
Volume16
Issue number6
Number of pages9
ISSN2072-6694
DOIs
Publication statusPublished - Mar 2024

Keywords

  • cytoreductive nephrectomy
  • real world data
  • renal cell carcinoma

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