title: Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer.
abstract: BACKGROUND
  The value of nephrectomy in metastatic renal-cell cancer has long been debated. Several nonrandomized studies suggest a higher rate of response to systemic therapy and longer survival in patients who have undergone nephrectomy.
  
  
  METHODS
  We randomly assigned patients with metastatic renal-cell cancer who were acceptable candidates for nephrectomy to undergo radical nephrectomy followed by therapy with interferon alfa-2b or to receive interferon alfa-2b therapy alone. The primary end point was survival, and the secondary end point was a response of the tumor to treatment.
  
  
  RESULTS
  The median survival of 120 eligible patients assigned to surgery followed by interferon was 11.1 months, and among the 121 eligible patients assigned to interferon alone it was 8.1 months (P=0.05). The difference in median survival between the two groups was independent of performance status, metastatic site, and the presence or absence of a measurable metastatic lesion.
  
  
  CONCLUSIONS
  Nephrectomy followed by interferon therapy results in longer survival among patients with metastatic renal-cell cancer than does interferon therapy alone.
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, Ill., USA. rflanig@luc.edu
authors.forename: R C
authors.initials: RC
authors.lastname: Flanigan
authors.forename: S E
authors.initials: SE
authors.lastname: Salmon
authors.forename: B A
authors.initials: BA
authors.lastname: Blumenstein
authors.forename: S I
authors.initials: SI
authors.lastname: Bearman
authors.forename: V
authors.initials: V
authors.lastname: Roy
authors.forename: P C
authors.initials: PC
authors.lastname: McGrath
authors.forename: J R
authors.initials: JR
authors.lastname: Caton
authors.forename: N
authors.initials: N
authors.lastname: Munshi
authors.forename: E D
authors.initials: ED
authors.lastname: Crawford
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009392:Nephrectomy; D011994:Recombinant Proteins; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins