title: Cytoreductive partial nephrectomy does not undermine cancer control in metastatic renal cell carcinoma: a population-based study.
abstract: OBJECTIVE
  We examined the population-based rates of cancer-specific survival in patients with metastatic renal cell carcinoma (MRCC) treated with either partial (PN) or radical cytoreductive nephrectomy (RN).
  
  
  METHODS
  Patients diagnosed with MRCC and treated with either PN or RN were identified within nine SEER cancer registries. Matched and unmatched Kaplan-Meier survival analyses, as well as multivariable Cox regression models compared the effect of RN (n = 1997, 97.8%) vs. PN (n = 46, 2.2%) on cancer-specific survival (CSS). Covariates consisted of age, gender, community type (rural vs urban), race, Surveillance, Epidemiology, and End Results (SEER) registry, tumor size and year of diagnosis.
  
  
  RESULTS
  In multivariable unmatched Cox regression analyses, no statistically significantly difference was found in CSS between the two groups (hazard ratio [HR] 1.40, P = .16). Similarly, no difference in CSS was found in the matched analyses (HR 1.35, log rank P = .34).
  
  
  CONCLUSIONS
  Cytoreductive PN does not appear to undermine survival in patients with MRCC.
authors.affiliation: Department of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Umberto
authors.initials: U
authors.lastname: Capitanio
authors.forename: Laurent
authors.initials: L
authors.lastname: Zini
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Claudio
authors.initials: C
authors.lastname: Jeldres
authors.forename: Philippe
authors.initials: P
authors.lastname: Arjane
authors.forename: Daniel
authors.initials: D
authors.lastname: Pharand
authors.forename: Hugues
authors.initials: H
authors.lastname: Widmer
authors.forename: François
authors.initials: F
authors.lastname: Péloquin
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology