It is unknown whether previously reported other-cause mortality (OCM) advantage of partial cytoreductive nephrectomy (PCN) vs. radical cytoreductive nephrectomy (RCN) still applies to contemporary clear cell metastatic renal cell carcinoma (ccmRCC) patients.
We relied on the Surveillance, Epidemiology and End Results (SEER) database (2004-2019) to identify ccmRCC patients treated with PCN and RCN. Temporal trends of PCN rates within the SEER database were tabulated. After propensity score matching (PSM), cumulative incidence plots depicted 5-year OCM and cancer-specific mortality (CSM) of PCN and RCN patients. Multivariable Cox regression models tested for differences between PCN vs. RCN.
Of 5149 study patients, 237 (5%) underwent PCN vs. 4912 (95%) RCN. In the SEER database 2004 to 2019, rates of PCN in ccmRCC patients increased from 3.0% to 8.0% (estimated annual percent change [EAPC]: 3.0%; P = .04). After PSM, 5-year OCM rates were 2.4 vs. 7.5% for respectively PCN vs. RCN patients (P = .036). 5-year CSM rates were 50.8 vs. 53.6% for respectively PCN and RCN patients (P = .57). In multivariable Cox regression models, PCN was associated with lower OCM (Hazard Ratio (HR): 0.39; 95% confidence interval (CI): 0.18-0.84; P = .02) but did not affect CSM rates (HR: 0.99; 95% CI: 0.76-1.29; P = .96).
We confirm the existence of OCM advantage after PCN vs. RCN in contemporary ccmRCC patients.
Clinical genitourinary cancer. 2023 Jun 12 [Epub ahead of print]
Cristina Cano Garcia, Rocco S Flammia, Mattia Piccinelli, Andrea Panunzio, Stefano Tappero, Francesco Barletta, Reha-Baris Incesu, Kyle W Law, Simone Morra, Zhe Tian, Fred Saad, Anil Kapoor, Shahrokh F Shariat, Nicola Longo, Derya Tilki, Alberto Briganti, Carlo Terrone, Alessandro Antonelli, Ottavio De Cobelli, Benedikt Hoeh, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz
Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt, Germany. Electronic address: ., Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Martino, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada., Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Reproductive Sciences, and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy., Division of Urology, McMaster Institute of Urology, McMaster University, Hamilton, Ontario, Canada., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Hourani Center of Applied Scientific Research, Department of Urology, Al-Ahliyya Amman University, Amman, Jordan., Department of Neurosciences, Reproductive Sciences, and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy., Martini-Klinik, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey., Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, IRCCS Policlinico San Martino, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy., Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy., Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy., Department of Urology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt, Germany.