title: The necessity of cytoreductive nephrectomy in patients with metastatic renal cell carcinoma using antiangiogenic targeted therapy after interferon alfa-2b.
abstract: BACKGROUND
  Targeted therapy has improved the survival of patients with metastatic RCC. In the present study, we evaluated whether there was an effect of cytoreductive surgery on prognosis of patients with metastatic RCC using antiangiogenic tyrosine kinase inhibitor (TKI) agents.
  
  
  METHODS
  A total of 52 patients with metastatic RCC from Akdeniz University, Afyon Kocatepe University, and Medipol University participated in the study. All the patients had received targeted antiangiogenic therapy after interferon alfa-2b. According to previous CRN, the patients were divided into 2 groups as CRN (+) and CRN (-).
  
  
  RESULTS
  The CRN (+) group was younger than the CRN (-) group (P < .001) and the hemoglobin levels were significantly higher in the CRN (+) group (P = .023). The median progression-free survival time from the date of starting TKIs were 8.5 and 3.0 months for the CRN (+) and CRN (-) groups, respectively (P = .104). The median overall survival was 15.1 and 5.4 months for the CRN (+) and CRN (-) groups, respectively (P = .034).
  
  
  CONCLUSIONS
  We speculate that CRN is still an important part of treatment modalities in patients with metastatic RCC in modern era targeted therapy, which is currently the best systemic therapy. However, the indications of CRN might be limited to good-risk patients with metastatic RCC. Further randomized studies are warranted to clarify the necessity of CRN in patients with metastatic RCC.
authors.affiliation: Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey. Electronic address: doktorhasanmutlu@gmail.com.
authors.forename: Hasan
authors.initials: H
authors.lastname: Mutlu
authors.affiliation: Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Seyda
authors.initials: S
authors.lastname: Gündüz
authors.affiliation: Department of Internal Medicine, Acıbadem University School of Medicine, Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Büyükçelik
authors.affiliation: Department of Medical Oncology, Medipol University, Istanbul, Turkey.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Yıldız
authors.affiliation: Department of Medical Oncology, Kocatepe University School of Medicine, Afyon, Turkey.
authors.forename: Mükremin
authors.initials: M
authors.lastname: Uysal
authors.affiliation: Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Tural
authors.affiliation: Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Bozcuk
authors.affiliation: Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Hasan Şenol
authors.initials: HŞ
authors.lastname: Coşkun
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
keywords: Angiogenesis; Nephrectomy; Prognosis; Renal cell cancer; Survival