Heng D.Y.C., Wells J.C., Rini B.I., Beuselinck B., Lee J.-L., Knox J.J., Bjarnason G.A., Pal S.K., Kollmannsberger C.K., Yuasa T., Srinivas S., Donskov F., Bamias A., Wood L.A., Ernst D.S., Agarwal N., Vaishampayan U.N., Rha S.Y., Kim J.J., Choueiri T.K.
European Urology 2014 66:4 (704-710)
Background The benefit of cytoreductive nephrectomy (CN) for overall survival (OS) is unclear in patients with synchronous metastatic renal cell carcinoma (mRCC) in the era of targeted therapy. Objective To determine OS benefit of CN compared with no CN in mRCC patients treated with targeted therapies. Design, setting, and participants Retrospective data from patients with synchronous mRCC (n = 1658) from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) were used to compare 982 mRCC patients who had a CN with 676 mRCC patients who did not. Outcome measurements and statistical analysis OS was compared and hazard ratios (HRs) adjusted for IMDC poor prognostic criteria. Results and limitations Patients who had CN had better IMDC prognostic profiles versus those without (favorable, intermediate, or poor in 9%, 63%, and 28% vs 1%, 45%, and 54%, respectively)…(ver más)