PD03-04 IS CYTOREDUCTIVE NEPHRECTOMY NECESSARY IN METASTATIC RENAL CELL CARCINOMA WITH PRIMARY KIDNEY TUMOR IN SITU TREATED BY SUNITINIB: REAL WORLD DATA FROM A SINGLE CHINESE CENTER

Field: Medicine (Health Sciences)

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (PD03)1 Apr 2019PD03-04 IS CYTOREDUCTIVE NEPHRECTOMY NECESSARY IN METASTATIC RENAL CELL CARCINOMA WITH PRIMARY KIDNEY TUMOR IN SITU TREATED BY SUNITINIB: REAL WORLD DATA FROM A SINGLE CHINESE CENTER Wen-Hao Xu, Wang Jun, Hong-Kai Wang, Fang-Ning Wan, Da-Long Cao, Yuan-Yuan Qu*, Hai-Liang Zhang, and Dingwei Ye Wen-Hao XuWen-Hao Xu More articles by this author , Wang JunWang Jun More articles by this author , Hong-Kai WangHong-Kai Wang More articles by this author , Fang-Ning WanFang-Ning Wan More articles by this author , Da-Long CaoDa-Long Cao More articles by this author , Yuan-Yuan Qu*Yuan-Yuan Qu* More articles by this author , Hai-Liang ZhangHai-Liang Zhang More articles by this author , and Dingwei YeDingwei Ye More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555040.26318.38AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: To evaluate the role of cytoreductive nephrectomy (CN), which was an indispensable treatment in metastasis renal cell carcinoma (mRCC), compared with cytokine treatment, we assessed the survival benefit of CN in patients with mRCC treated by sunitinib in targeted therapy era. METHODS: This retrospective study compared the progression-free survival (PFS) and overall survival (OS) between mRCC patients who did or did not undergo CN. We screened out and enrolled patients from April 2006 to November 2013 as suitable candidates for CN with primary kidney tumor in situ. Logistic regression models were used to measure the effects of the clinical and pathological covariates. The Kaplan-Meier method and log-rank test were performed to evaluate the possible survival differences between two groups. RESULTS: 70 patients were assigned to undergo CN followed with sunitinib and 48 received sunitinib alone. According to the survival analysis, the median PFS was 8.38 months and the median OS was 15.48 months, with 109 deaths observed. There were no significant difference between CN-sunitinib group and sunitinib-alone group in both PFS(7.2 versus 11.6 months, 95% confidence interval, 5.3 to 11.8; P=0.525) and OS (16.7 versus 15.2 months, 95% confidence interval, 12.0 to 18.9, P=0.839). However, stratified analysis revealed that PFS and OS might decrease after CN in the subgroups of patients with IMDC prognostic criteria of high-risk disease (PFS: 4.4 [95% CI, 3.5 to 5.3] vs. 6.3 [95% CI, 5.3 to 7.2]months, P=0.002; OS: 8.8 [95% CI, 7.0 to 10.6] vs 9.9 [95% CI, 10.0 to 11.8] months, P=0.011) and those with lymphatic metastasis (PFS: 4.4 [95% CI, 2.9 to 6.0] vs. 6.6 [95% CI, 2.1 to 11.2] months, P<0.001; OS: 8.8 [95% CI, 6.9 to 10.7] vs 9.9 [95% CI, 7.1 to 10.7] months, P=0.006). CONCLUSIONS: Cytoreductive nephrectomy may offer no survival benefits in those mRCC patients with primary kidney tumor in situ, and moreover, sunitinib-alone therapy perhaps contributes longer PFS and OS for the patients with IMDC high-risk disease and those with lymphatic metastasis. Source of Funding: This work is supported by National Natural Science Foundation of China (NSFC) 81202004 and Shanghai Natural Science Foundation of China 16ZR1406400. Shanghai, China, People's Republic of© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e68-e68 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wen-Hao Xu More articles by this author Wang Jun More articles by this author Hong-Kai Wang More articles by this author Fang-Ning Wan More articles by this author Da-Long Cao More articles by this author Yuan-Yuan Qu* More articles by this author Hai-Liang Zhang More articles by this author Dingwei Ye More articles by this author Expand All Advertisement PDF downloadLoading ...