Benefit from cytoreductive nephrectomy and the prognostic role of neutrophil‐to‐lymphocyte ratio in patients with metastatic renal cell carcinoma

Day, Daphne; Kanjanapan, Yada; Kwan, Edmond M.; Yip, Desmond; Lawrentschuk, Nathan; Davis, Ian D.; Azad, Arun; Wong, Shirley; Rosenthal, Mark; Gibbs, Peter

doi:10.1111/imj.13202

Cited by 16 publications

(12 citation statements)

References 24 publications

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“…Two ongoing clinical trials were identified (NCT00930033 and NCT01099423); however, not enough data were yet available for analysis. Finally, seven studies were included in the qualitative analysis (eight publications) [ 14 15 16 17 18 19 20 21 ]; five of them [ 14 15 16 18 21 ] reported the HR for overall survival of CRN versus no intervention ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 22,507 patients were included, with a median of 3,215 patients per study. Seven studies (eight publications) reported overall survival and one study reported toxicities related to tyrosine kinase inhibitors [ 14 15 16 17 18 19 20 21 ]. You et al [ 15 16 ] reported two publications but of the same study.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies showed a higher survival rate for the CRN group ( Table 3 ). The studies by Day et al [ 14 ], You et al [ 15 ], Choueiri et al [ 17 ], , Heng et al [ 18 ], and Tatsugami et al [ 21 ], were included in the meta-analysis because they were the only studies that described the HRs for overall survival (CRN versus TT only). The overall result was an HR of 0.58 (95% CI, 0.50 to 0.65) ( Fig.…”

Section: Resultsmentioning

confidence: 99%

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Role of cytoreductive nephrectomy in the targeted therapy era: A systematic review and meta-analysis

2018

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PurposeTo determine the effectiveness and harm of cytoreductive nephrectomy versus no intervention in patients with metastatic renal carcinoma who undergo targeted therapy to improve overall survival.Materials and MethodsA search strategy was conducted in the MEDLINE, CENTRAL, Embase, HTA, DARE, NHS, and LILACS databases. Searches were also conducted for unpublished literature through references from relevant articles identified through the search, conferences, thesis databases, OpenGrey, Google Scholar, and clinicaltrials.gov, among others. Studies were included without language restrictions. The risk of bias assessment was made by using a modified Cochrane Collaboration tool. A meta-analysis of fixed effects was conducted. The expected outcomes were overall survival, quality of life, adverse effects, mortality, and progression- free survival. The measure of the effect was the hazard ratio (HR) with a 95% confidence interval (CI). The planned comparison was cytoreductive nephrectomy versus no intervention.ResultsA total of 22,507 patients were found among seven studies. Seven studies were included in the qualitative analysis (eight publications) and five in the quantitative analysis for overall survival. One study reported progression-free survival and one reported targeted therapy toxicities. A low risk of bias was shown for most of the study items. The HR for overall survival was 0.58 (95% CI, 0.50 to 0.65) favoring cytoreductive nephrectomy compared with no intervention.ConclusionsCytoreductive nephrectomy is effective for improving overall survival in patients with metastatic renal carcinoma who undergo targeted therapy compared with no intervention.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Role of cytoreductive nephrectomy in the targeted therapy era: A systematic review and meta-analysis

2018

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“…In addition to this randomized trial, several retrospective observational studies have investigated whether CN provides a survival advantage in patients receiving targeted therapy [6][7][8][9][10][11][12][13][14][15][16][17][18]. These observational studies are limited to a varying degree by heterogeneous patient populations, selection bias, confounding and as a result, the strength of their evidence and related conclusions regarding the benefits of CN are limited.…”

Section: Cuaj -Consensus Statementmentioning

confidence: 99%

“…These observational studies are limited to a varying degree by heterogeneous patient populations, selection bias, confounding and as a result, the strength of their evidence and related conclusions regarding the benefits of CN are limited. Despite these limitations, nearly all available observational studies have identified a significant survival advantage in favor of CN for patients treated with targeted therapies [6][7][8][9][10][11][12][13][14][15][16][17][18]. For example, in a well performed analysis from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) (one of only two studies including Canadian patients), a 40% reduction in all-cause mortality was noted among patients receiving CN after controlling for known biases and adjustment for confounders [13].…”

Section: Cuaj -Consensus Statementmentioning

confidence: 99%

Kidney Cancer Research Network of Canada (KCRNC) consensus statement on the role of cytoreductive nephrectomy for patients with metastatic renal cell carcinoma

Mason

Wood

Kapoor

et al. 2018

CUAJ

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Mason et al KCRNC consensus: Cytoreductive nephrectomy for mRCC several important questions remain surrounding the appropriate application of CN, particularly with regards to optimal patient selection and the timing of surgery.Herein, the Kidney Cancer Research Network of Canada (KCRNC) provides consensus recommendations on the role of CN in patients with mRCC in order to guide clinicians who manage patients with advanced RCC. Methods Evidence acquisitionA comprehensive search was conducted to identify studies relevant to the development of this consensus statement. Databases searched included MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and SCOPUS. The search strategy was designed and conducted by an experienced librarian with input from the consensus statement authors. The full search strategy can be found in the appendix. Consensus statement developmentThis consensus document was developed to address six questions related to CN that were judged to be the most relevant to patient care:1) Should patients with mRCC be offered CN and what is the optimal patient selection and timing? 2) Is there a role for CN in patients with non-clear cell mRCC? 3) Is there a role for biopsy prior to CN? 4) Is there a role for concomitant regional lymph node dissection during CN? 5) Is there a preferred surgical approach for CN? The statements contained herein were developed by consensus of the authors of this document, which include stakeholders across multiple specialties. CUAJ -Consensus StatementMason et al KCRNC consensus: Cytoreductive nephrectomy for mRCC Should patients with metastatic renal cell carcinoma be offered cytoreductive nephrectomy and what is the optimal patient selection and timing?

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Quantitative changes in blood cells

2021

Blood Cells

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Benefit from cytoreductive nephrectomy and the prognostic role of neutrophil‐to‐lymphocyte ratio in patients with metastatic renal cell carcinoma

Abstract: Background: The role of cytoreductive nephrectomy (CN) for metastatic renal cell car-

Cited by 16 publications

References 24 publications

Role of cytoreductive nephrectomy in the targeted therapy era: A systematic review and meta-analysis

Role of cytoreductive nephrectomy in the targeted therapy era: A systematic review and meta-analysis

Kidney Cancer Research Network of Canada (KCRNC) consensus statement on the role of cytoreductive nephrectomy for patients with metastatic renal cell carcinoma

Quantitative changes in blood cells

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