Cargando…

Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010

BACKGROUND: The purpose of this study was to evaluate the effects of cytoreductive nephrectomy (CN) and metastasectomies on the survival of patients with synchronous metastatic renal cell cancer (mRCC) using real-life, population-based national dataset. METHODS: Nationwide data, including all cases...

Descripción completa

Detalles Bibliográficos
Autores principales: Laru, Lauri, Ronkainen, Hanna, Ohtonen, Pasi, Vaarala, Markku H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240260/
https://www.ncbi.nlm.nih.gov/pubmed/34183025
http://dx.doi.org/10.1186/s12957-021-02308-0
_version_ 1783715178209083392
author Laru, Lauri
Ronkainen, Hanna
Ohtonen, Pasi
Vaarala, Markku H.
author_facet Laru, Lauri
Ronkainen, Hanna
Ohtonen, Pasi
Vaarala, Markku H.
author_sort Laru, Lauri
collection PubMed
description BACKGROUND: The purpose of this study was to evaluate the effects of cytoreductive nephrectomy (CN) and metastasectomies on the survival of patients with synchronous metastatic renal cell cancer (mRCC) using real-life, population-based national dataset. METHODS: Nationwide data, including all cases of synchronous mRCC in Finland diagnosed on a 6-year timeframe, based on the Finnish Cancer Registry and complemented with patient records from the treating hospitals, were analyzed. Patients with Eastern Cooperative Oncology Group (ECOG) performance status 3–4 were excluded. Univariate and adjusted multivariable survival analysis were performed, including subgroup analysis for patients with different medical therapies. Nephrectomy complications were also analyzed. RESULTS: A total of 732 patients were included in the analysis. CN was performed for 389 (53.1%) patients, whereas 68 (9.3%) patients underwent nephrectomy and metastasectomies of all lesions (surgery with curative intent). Median overall survival (OS) for patients who did not undergo nephrectomy was 5.9 (95% confidence interval [CI] = 4.6–7.2) months. Patients who had a CN had a median OS of 16.6 (95% CI = 14.2–19.1, p < 0.001) months, whereas patients who had surgery with curative intent had a median OS of 51.3 (95% CI = 36.0–66.6, p < 0.001) months. The survival benefit of CN and metastasectomies remained significant in all medical therapy subgroups and in both of the applied multivariable statistical models. CONCLUSIONS: Surgical treatment of metastatic renal cell cancer is associated with a significant survival benefit in patients with good and moderate performance status, regardless of the chosen medical therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-021-02308-0.
format Online
Article
Text
id pubmed-8240260
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-82402602021-06-29 Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010 Laru, Lauri Ronkainen, Hanna Ohtonen, Pasi Vaarala, Markku H. World J Surg Oncol Research BACKGROUND: The purpose of this study was to evaluate the effects of cytoreductive nephrectomy (CN) and metastasectomies on the survival of patients with synchronous metastatic renal cell cancer (mRCC) using real-life, population-based national dataset. METHODS: Nationwide data, including all cases of synchronous mRCC in Finland diagnosed on a 6-year timeframe, based on the Finnish Cancer Registry and complemented with patient records from the treating hospitals, were analyzed. Patients with Eastern Cooperative Oncology Group (ECOG) performance status 3–4 were excluded. Univariate and adjusted multivariable survival analysis were performed, including subgroup analysis for patients with different medical therapies. Nephrectomy complications were also analyzed. RESULTS: A total of 732 patients were included in the analysis. CN was performed for 389 (53.1%) patients, whereas 68 (9.3%) patients underwent nephrectomy and metastasectomies of all lesions (surgery with curative intent). Median overall survival (OS) for patients who did not undergo nephrectomy was 5.9 (95% confidence interval [CI] = 4.6–7.2) months. Patients who had a CN had a median OS of 16.6 (95% CI = 14.2–19.1, p < 0.001) months, whereas patients who had surgery with curative intent had a median OS of 51.3 (95% CI = 36.0–66.6, p < 0.001) months. The survival benefit of CN and metastasectomies remained significant in all medical therapy subgroups and in both of the applied multivariable statistical models. CONCLUSIONS: Surgical treatment of metastatic renal cell cancer is associated with a significant survival benefit in patients with good and moderate performance status, regardless of the chosen medical therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-021-02308-0. BioMed Central 2021-06-28 /pmc/articles/PMC8240260/ /pubmed/34183025 http://dx.doi.org/10.1186/s12957-021-02308-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Laru, Lauri
Ronkainen, Hanna
Ohtonen, Pasi
Vaarala, Markku H.
Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010
title Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010
title_full Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010
title_fullStr Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010
title_full_unstemmed Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010
title_short Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010
title_sort nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a finnish nation-wide population-based study from 2005 to 2010
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240260/
https://www.ncbi.nlm.nih.gov/pubmed/34183025
http://dx.doi.org/10.1186/s12957-021-02308-0
work_keys_str_mv AT larulauri nephrectomyimprovesthesurvivalofmetastaticrenalcellcancerpatientswithmoderatetogoodperformancestatusresultsfromafinnishnationwidepopulationbasedstudyfrom2005to2010
AT ronkainenhanna nephrectomyimprovesthesurvivalofmetastaticrenalcellcancerpatientswithmoderatetogoodperformancestatusresultsfromafinnishnationwidepopulationbasedstudyfrom2005to2010
AT ohtonenpasi nephrectomyimprovesthesurvivalofmetastaticrenalcellcancerpatientswithmoderatetogoodperformancestatusresultsfromafinnishnationwidepopulationbasedstudyfrom2005to2010
AT vaaralamarkkuh nephrectomyimprovesthesurvivalofmetastaticrenalcellcancerpatientswithmoderatetogoodperformancestatusresultsfromafinnishnationwidepopulationbasedstudyfrom2005to2010