The authors analyzed 351 patients with metastatic kidney cancer for a possible impact of cytoreductive nephrectomy. Median overall survival (OS) of all patients was 37.1 months. Patients with nephrectomy had longer OS compared to patients without (38.1 months versus 16.4 months, p<0.001). This benefit was only present in patients with ECOG 0 or 1 (median OS 43.3 months versus 16.7 months, p<0.03) but not in patients with ECOG 2 or 3 (median OS 12.6 months versus 8 months, p=0.8). This observation was also present for MSKCC criteria. Patients with good and intermediate risk had a median OS of 42.4 months following nephrectomy compared to 16.8 months in patients without nephrectomy (p=0.02). Patients with poor risk had similar OS (5.2 months versus 5.2 months (p=0.9). The authors concluded that nephrectomy improves OS in patients with metastatic kidney cancer but only in patients with ECOG 0 or and MSKCC good or intermediate.
In the two SWOG and EOTRC trials demonstrating a survival benefit for patients undergoing nephrectomy plus Interferon compared to Interferon alone only, patients with ECOG 0 or 1 were included. These results are now confirmed by this retrospective study. Unfortunately, patients with poor performance status and/or MSKCC high risk have short OS despite systemic and/or operative therapy.
Presented by Maxime Crépel, MD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria
Reported for UroToday by Christian Doehn, MD, PhD, Department of Urology, University of Lübeck Medical School, Lübeck Germany.
View EAU 2011 Annual Meeting Coverage
