التفاصيل البيبلوغرافية
| العنوان: |
The Impact of Cytoreductive Nephrectomy on Survival of Patients With Metastatic Renal Cell Carcinoma Receiving Vascular Endothelial Growth Factor Targeted Therapy. |
| المؤلفون: |
Choueiri, Toni K., Xie, Wanling, Kollmannsberger, Christian, North, Scott, Knox, Jennifer J., Lampard, J. Geoffrey, McDermott, David F., Rini, Brian I., Heng, Daniel Y.C. |
| المصدر: |
Journal of Urology; Jan2011, Vol. 185 Issue 1, p60-66, 7p |
| مصطلحات موضوعية: |
CANCER treatment, RENAL cell carcinoma, METASTASIS, VASCULAR endothelial growth factors, RETROSPECTIVE studies, HEALTH outcome assessment, LACTATE dehydrogenase, MEDICAL statistics |
| مستخلص: |
Purpose: Vascular endothelial growth factor targeted therapy is a standard of care in patients with metastatic renal cell carcinoma. The role of cytoreductive nephrectomy in the era of novel agents remains poorly defined. Materials and Methods: We retrospectively reviewed baseline characteristics and outcomes of 314 patients with anti-vascular endothelial growth factor therapy naïve, metastatic renal cell carcinoma from United States and Canadian cancer centers to study the impact of cytoreductive nephrectomy on overall survival. Results: Patients who underwent cytoreductive nephrectomy (201) were younger (p <0.01), and more likely to have a better Karnofsky performance status (p <0.01), more than 1 site of metastasis (p = 0.04) and lower corrected calcium levels (p <0.01) compared to those who did not undergo cytoreductive nephrectomy (113). On univariable analysis cytoreductive nephrectomy was associated with a median overall survival of 19.8 months compared to 9.4 months for patients who did not undergo cytoreductive nephrectomy (HR 0.44; 95% CI 0.32, 0.59; p <0.01). On multivariable analysis and adjusting for established prognostic risk factors the overall survival difference persisted (adjusted HR 0.68; 95% CI 0.46, 0.99; p = 0.04) in favor of the cytoreductive nephrectomy group. In subgroup analyses stratified for favorable/intermediate/poor risk criteria, patients in the poor risk group had a marginal benefit (p = 0.06). Similarly patients with Karnofsky performance status less than 80% also had a marginal survival benefit (p = 0.08). Conclusions: In this retrospective study cytoreductive nephrectomy was independently associated with a prolonged overall survival of patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor targeted agents, although the benefit is marginal in those patients with poor risk features. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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