Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy-Data from the National Renis Registry.
Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy-Data from the National Renis Registry.
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DOI：
10.3390/cancers12102911
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发表时间：
2020-10-10
期刊：
影响因子：
5.2
通讯作者：
Buchler T
中科院分区：
文献类型：
--
作者：
Poprach A;Holanek M;Chloupkova R;Lakomy R;Stanik M;Fiala O;Melichar B;Kopeckova K;Zemanova M;Kiss I;Penka I;Bohosova J;Buchler T
传统上，转移性肾细胞癌的治疗开始于切除病变肾脏和肿瘤。然而，如果使用靶向治疗，关于肾脏切除的益处仍存在争议。本文分析了一大批患者，结果表明，在接受靶向治疗的患者中，仍应强烈考虑原发肿瘤切除。在靶向治疗（TT）时代，细胞减减性肾切除术（CN）在治疗局部晚期或转移性肾细胞癌（mRCC）中的作用仍未明确定义。研究人群包括730例同步mRCC患者。使用RenIS（肾癌信息系统）注册表作为数据源。CN/TT队列包括在mRCC诊断后3个月内患有CN并随后接受TT治疗的患者，而TT队列包括预先接受TT治疗的患者。TT组的中位无进展生存期为6.7个月，CN/TT组的中位无进展生存期为9.3个月（p < 0.001）。中位总生存期分别为14.2个月和27.2个月（p < 0.001）。肝转移、高级别肿瘤、CN缺失、不透明细胞组织学和MSKCC （Memorial Sloan-Kettering Cancer Center）不良预后状况与不良治疗结果相关。根据这项回顾性研究的结果，接受CN并随后接受TT治疗的患者与接受前期TT治疗的患者相比具有更好的预后。本研究结果支持在mRCC的治疗算法中使用CN。
The treatment of metastatic renal cell carcinoma is traditionally initiated with the removal of the diseased kidney with the tumor in many patients. However, there is ongoing controversy about the benefit of kidney removal if targeted therapy is used. The present paper analyses a large cohort of patients, and the results indicate that primary tumor removal should still be strongly considered in patients who are treated with targeted therapies. The role of cytoreductive nephrectomy (CN) in treatment of locally advanced or metastatic renal cell carcinoma (mRCC) in the era of targeted therapies (TT) is still not clearly defined. The study population consisted of 730 patients with synchronous mRCC. The RenIS (Renal carcinoma Information System) registry was used as the data source. The CN/TT cohort included patients having CN within 3 months from the mRCC diagnosis and subsequently being treated with TT, while the TT cohort included patients receiving TT upfront. Median progression-free survival from the first intervention was 6.7 months in the TT arm and 9.3 months in the CN/TT patients (p < 0.001). Median overall survival was 14.2 and 27.2 months, respectively (p < 0.001). Liver metastasis, high-grade tumor, absence of CN, non-clear cell histology, and MSKCC (Memorial Sloan-Kettering Cancer Center) poor prognosis status were associated with adverse treatment outcomes. According to the results of this retrospective study, patients who underwent CN and subsequently were treated with TT had better outcomes compared to patients treated with upfront TT. The results of the study support the use of CN in the treatment algorithm for mRCC.
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影响因子：
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