| Autor: |
Margaret F. Meagher, Andrea Minervini, Maria C. Mir, Clara Cerrato, Giacomo Rebez, Riccardo Autorino, Lance Hampton, Riccardo Campi, Maximilian Kriegmair, Estefania Linares, Vital Hevia, Maria Musquera, Mauricio D'Anna, Eduard Roussel, Maarten Albersen, Nicola Pavan, Francesco Claps, Alessandro Antonelli, Michele Marchioni, Nail Paksoy, Selcuk Erdem, Ithaar H. Derweesh |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
European Urology Open Science, Vol 63, Iss , Pp 71-80 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2666-1683 |
| DOI: |
10.1016/j.euros.2024.02.001 |
| Popis: |
Background and objective: The role of cytoreductive nephrectomy (CN) in the treatment of metastatic renal cell carcinoma (mRCC) has been called into question on the basis of clinical trial data from the tyrosine kinase inhibitor (TKI) era. Comparative analyses of CN for patients treated with immuno-oncology (IO) versus TKI agents are sparse. Our objective was to compare CN timing and outcomes among patients who received TKI versus IO therapy. Methods: This was a multicenter retrospective analysis of patients who underwent CN using data from the REMARCC (Registry of Metastatic RCC) database. The cohort was divided into TKI versus IO first-line therapy groups. The primary outcome was all-cause mortality (ACM). Secondary outcomes included cancer-specific mortality (CSM). Multivariable analysis was used to identify factors predictive for ACM and CSM. The Kaplan-Meier method was used to analyze 5-yr overall survival (OS) and cancer-specific survival (CSS) with stratification by primary systemic therapy and timing in relation to CN. Key findings and limitations: We analyzed data for 189 patients (148 TKI + CN, 41 IO +CN; median follow-up 23.2 mo). Multivariable analysis revealed that a greater number of metastases (hazard ratio [HR] 1.06; p = 0.015), greater primary tumor size (HR 1.10; p = 0.043), TKI receipt (HR 2.36; p = 0.015), and initiation of systemic therapy after CN (HR 1.49; p = 0.039) were associated with worse ACM. A greater number of metastases at diagnosis (HR 1.07; p = 0.011), greater primary tumor size (HR 1.12; p = 0.018), TKI receipt (HR 5.43; p = 0.004), and initiation of systemic therapy after CN (HR 2.04; p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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