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Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy—Data from the National Renis Registry

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Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic
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Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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Department of Urologic Oncology, Masaryk Memorial Cancer Institute and Masaryk University, 656 53 Brno, Czech Republic
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Department of Oncology, University Hospital, 323 00 Pilsen, Czech Republic
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Department of Oncology, Palacky University Medical School and Teaching Hospital, 779 00 Olomouc, Czech Republic
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University Hospital in Hradec Kralove, 500 05 Hradec Kralove, Czech Republic
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Department of Oncology, Motol University Hospital and 2nd Faculty of Medicine Charles University, 150 06 Prague, Czech Republic
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Department of Oncology, First Faculty of Medicine Charles University and General University Hospital, 120 00 Prague, Czech Republic
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Department of Surgery, University Hospital Bohunice, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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Central European Institute of Technology (CEITEC), University Campus Bohunice, Masaryk University, 625 00 Brno, Czech Republic
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Department of Oncology, First Faculty of Medicine, Thomayer Hospital and Charles University, 140 59 Prague, Czech Republic
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(10), 2911; https://doi.org/10.3390/cancers12102911
Received: 31 August 2020 / Revised: 30 September 2020 / Accepted: 8 October 2020 / Published: 10 October 2020
(This article belongs to the Section Cancer Therapy)
The treatment of metastatic renal cell carcinoma is traditionally initiated with the removal of the diseased kidney with the tumor in many patients. However, there is ongoing controversy about the benefit of kidney removal if targeted therapy is used. The present paper analyses a large cohort of patients, and the results indicate that primary tumor removal should still be strongly considered in patients who are treated with targeted therapies.
The role of cytoreductive nephrectomy (CN) in treatment of locally advanced or metastatic renal cell carcinoma (mRCC) in the era of targeted therapies (TT) is still not clearly defined. The study population consisted of 730 patients with synchronous mRCC. The RenIS (Renal carcinoma Information System) registry was used as the data source. The CN/TT cohort included patients having CN within 3 months from the mRCC diagnosis and subsequently being treated with TT, while the TT cohort included patients receiving TT upfront. Median progression-free survival from the first intervention was 6.7 months in the TT arm and 9.3 months in the CN/TT patients (p < 0.001). Median overall survival was 14.2 and 27.2 months, respectively (p < 0.001). Liver metastasis, high-grade tumor, absence of CN, non-clear cell histology, and MSKCC (Memorial Sloan-Kettering Cancer Center) poor prognosis status were associated with adverse treatment outcomes. According to the results of this retrospective study, patients who underwent CN and subsequently were treated with TT had better outcomes compared to patients treated with upfront TT. The results of the study support the use of CN in the treatment algorithm for mRCC. View Full-Text
Keywords: metastatic renal cell carcinoma; targeted therapy; cytoreductive nephrectomy; overall survival metastatic renal cell carcinoma; targeted therapy; cytoreductive nephrectomy; overall survival
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MDPI and ACS Style

Poprach, A.; Holanek, M.; Chloupkova, R.; Lakomy, R.; Stanik, M.; Fiala, O.; Melichar, B.; Kopeckova, K.; Zemanova, M.; Kiss, I.; Penka, I.; Bohosova, J.; Buchler, T. Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy—Data from the National Renis Registry. Cancers 2020, 12, 2911. https://doi.org/10.3390/cancers12102911

AMA Style

Poprach A, Holanek M, Chloupkova R, Lakomy R, Stanik M, Fiala O, Melichar B, Kopeckova K, Zemanova M, Kiss I, Penka I, Bohosova J, Buchler T. Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy—Data from the National Renis Registry. Cancers. 2020; 12(10):2911. https://doi.org/10.3390/cancers12102911

Chicago/Turabian Style

Poprach, Alexandr, Milos Holanek, Renata Chloupkova, Radek Lakomy, Michal Stanik, Ondrej Fiala, Bohuslav Melichar, Katerina Kopeckova, Milada Zemanova, Igor Kiss, Igor Penka, Julia Bohosova, and Tomas Buchler. 2020. "Cytoreductive Nephrectomy and Overall Survival of Patients with Metastatic Renal Cell Carcinoma Treated with Targeted Therapy—Data from the National Renis Registry" Cancers 12, no. 10: 2911. https://doi.org/10.3390/cancers12102911

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