التفاصيل البيبلوغرافية
| العنوان: |
Outcome benefits of upfront cytoreductive nephrectomy for patients with metastatic renal cell carcinoma: An analysis of the TriNetX database |
| المؤلفون: |
Lai, Gu-Shun, Li, Jian-Ri, Wang, Shian-Shiang, Chen, Chuan-Shu, Yang, Chun-Kuang, Lin, Chia-Yen, Hung, Sheng-Chun, Chiu, Kun-Yuan, Yang, Shun-Fa |
| المساهمون: |
Püsküllüoğlu, Mirosława |
| المصدر: |
PLOS ONE ; volume 19, issue 3, page e0299102 ; ISSN 1932-6203 |
| بيانات النشر: |
Public Library of Science (PLoS) |
| سنة النشر: |
2024 |
| المجموعة: |
PLOS Publications (via CrossRef) |
| الوصف: |
Background The role of upfront cytoreductive nephrectomy remains debatable in the present era of tyrosine kinase inhibitors and immune checkpoint inhibitors. Here, we aimed to evaluate the outcomes of metastatic renal cell carcinoma patients treated with upfront CN and modern systemic therapies. Methods Using the TriNetX network database, we identified patients, in the period from 2008 to 2022, who were diagnosed with metastatic renal cell carcinoma, receiving first-line systemic therapies with tyrosine kinase inhibitors or immune checkpoint inhibitors. Their overall survivals were evaluated using the Kaplan-Meier method as well as multivariable regressions. Results We identified 11,094 patients with metastatic renal cell carcinoma. Of them, 2,914 (43%) patients in the tyrosine kinase inhibitor cohort (n = 6,779), and 1,884 (43.7%) in the immune checkpoint inhibitors cohort (n = 4315) underwent upfront cytoreductive nephrectomy. Those receiving upfront cytoreductive nephrectomy showed survival advantages with either tyrosine kinase inhibitor (Hazard ratio 0.722, 95% Confidence interval 0.67–0.73, p<0.001) or immune checkpoint inhibitors (Hazard ratio 65.1, 95% Confidence interval 0.59–0.71, p<0.001). In multivariable analysis, upfront cytoreductive nephrectomy was a factor for improved OS in both cohorts: tyrosine kinase inhibitors (Hazard ratio 0.623, 95% Confidence interval 0.56–0.694, p<0.001) and immune checkpoint inhibitors cohort (Hazard ratio 0.688, 95% Confidence interval 0.607–0.779, p<0.001). Conclusions Upfront cytoreductive nephrectomy was associated with an improved overall survival for patients with metastatic renal cell carcinoma receiving either first-line tyrosine kinase inhibitors or immune checkpoint inhibitors. Our results support a clinical role of upfront cytoreductive nephrectomy in the modern era. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1371/journal.pone.0299102 |
| الإتاحة: |
https://doi.org/10.1371/journal.pone.0299102Test |
| حقوق: |
http://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.900490CF |
| قاعدة البيانات: |
BASE |
