Survival of patients undergoing cytoreductive surgery for metastatic renal cell carcinoma in the targeted-therapy era.
OBJECTIVE
In the cytokine era, cytoreductive nephrectomy (CN) improves survival for patients with metastatic renal cell carcinoma (mRCC). We analyzed the effect of CN on the survival of patients diagnosed with mRCC in the era of tyrosine kinase inhibitors (2005-present).


METHODS
The Surveillance, Epidemiology, and End Results (SEER) database was used to identify adult patients diagnosed with mRCC between 2005 and 2009. The primary outcome was overall survival, analyzed with multivariable Cox models.


RESULTS
Out of 7,143 incident mRCC cases reported to SEER between 2005-2009, 2,629 (37%) underwent CN. Patients undergoing CN were younger, and more likely to be white, male, and married. Patients with stage T3 tumors were most likely to undergo CN (64%). Patients that underwent CN had improved one-year survival (61% vs. 22%). On multivariable analysis, CN was associated with improved overall survival(hazard ratio[HR]=0.40 95% confidence interval [CI]=0.37-0.43).


CONCLUSIONS
In the targeted-therapy era, patients with mRCC undergoing CN have improved survival after adjusting for tumor stage and demographic characteristics.
820 S. Wood Street Suite 515, Chicago, IL, 60612, U.S.A. mabern1@uic.edu.
Michael R
MR
Abern
Emelian
E
Scosyrev
Matvey
M
Tsivian
Edward M
EM
Messing
Thomas J
TJ
Polascik
Arkadiusz Z
AZ
Dudek
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009392:Nephrectomy; D016016:Proportional Hazards Models; D018426:SEER Program; D016896:Treatment Outcome
D000970:Antineoplastic Agents
Renal cell carcinoma; cytoreductive nephrectomy; targeted therapy; tyrosine kinase inhibitor