Complete metastasectomy in renal cell carcinoma: a propensity-score matched by the International Metastatic RCC Database Consortium prognostic model
| Autor: | Augusto Obuti Saito, Aldo Lourenço Abbade Dettino, Vinicius Fernando Calsavara, Walter Henriques da Costa, Daniel Vilarim Araujo, Stênio de Cássio Zequi, Maria Nirvana Formiga, Isabela Werneck da Cunha, Aline Fusco Fares |
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| Rok vydání: | 2019 |
| Předmět: |
Cancer Research
030232 urology & nephrology clear cell renal cell carcinoma computer.software_genre 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma medicine propensity score matching Database business.industry Hazard ratio Cancer targeted therapy medicine.disease Clear cell renal cell carcinoma Oncology 030220 oncology & carcinogenesis Propensity score matching Clinical Study Prognostic model Complete Metastasectomy Metastasectomy metastasectomy business computer |
| Zdroj: | ecancermedicalscience |
| ISSN: | 1754-6605 |
| DOI: | 10.3332/ecancer.2019.967 |
| Popis: | Introduction We evaluated overall survival (OS) benefit of complete metastasectomy (CM) in metastatic renal cell carcinoma (mRCC) using a propensity score-matched (PSM) analysis to balance groups by age, gender and by the International Metastatic RCC Database Consortium prognostic model (IMDC). Methods We included patients (pts) treated at the AC Camargo Cancer Center between 2007 and 2016. Pairs were matched by age, gender and IMDC. Kaplan–Meier survival estimates and Cox proportional hazard models were used to evaluate OS on CM and no-CM group. Results We found 116 pts with clear cell mRCC. After PSM, the number was reduced to 74 (37 CM, 37 no-CM). The median OS for CM and no-CM was 98.3 months and 40.5 months, respectively (hazard ratio 0.24 95%CI 0.11–0.53 p < 0.001). The OS benefit of CM was confirmed on favourable and intermediate IMDC but was absent on poor IMDC. The CM group received less systemic therapy than the no-CM group. Ten pts in the CM group still have no evidence of disease (NED). Conclusion After matching for age, gender and IMDC, we found CM impacts on OS and also diminishes the need for systemic treatment. Survival benefit was confirmed for favourable/intermediate IMDC but not for the poor IMDC prognostic model. Further studies correlating IMDC and metastasectomy are needed to guide clinical decision-making. |
| Databáze: | OpenAIRE |
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