Cytoreductive Nephrectomy and Metastatic Renal Cell Carcinoma: State of the Art and Future Perspectives

Napolitano, Luigi; Manfredi, Celeste; Cirillo, Luigi; Fusco, Giovanni Maria; Passaro, Francesco; Rocca, Roberto La; Mastrangelo, F; Spirito, Lorenzo; Pandolfo, Savio Domenico; Crocetto, Felice; Arcaniolo, Davide; Barone, Biagio

doi:10.3390/medicina59040767

Cited by 12 publications

(10 citation statements)

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“…Symptoms related to RCC are usually rare, and occur in the late stages [ 83 , 84 , 85 ]. In this context, several microRNAs have been tested and identified as early diagnostic markers or as useful tools in the follow-up of treated patients [ 86 ].…”

Section: Resultsmentioning

confidence: 99%

Urinary MicroRNAs as Biomarkers of Urological Cancers: A Systematic Review

Aveta

Cilio

Contieri

et al. 2023

IJMS

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MicroRNAs (miRNAs) are emerging as biomarkers for the detection and prognosis of cancers due to their inherent stability and resilience. To summarize the evidence regarding the role of urinary miRNAs (umiRNAs) in the detection, prognosis, and therapy of genitourinary cancers, we performed a systematic review of the most important scientific databases using the following keywords: (urinary miRNA) AND (prostate cancer); (urinary miRNA) AND (bladder cancer); (urinary miRNA) AND (renal cancer); (urinary miRNA) AND (testicular cancer); (urinary miRNA) AND (urothelial cancer). Of all, 1364 articles were screened. Only original studies in the English language on human specimens were considered for inclusion in our systematic review. Thus, a convenient sample of 60 original articles was identified. UmiRNAs are up- or downregulated in prostate cancer and may serve as potential non-invasive molecular biomarkers. Several umiRNAs have been identified as diagnostic biomarkers of urothelial carcinoma and bladder cancer (BC), allowing us to discriminate malignant from nonmalignant forms of hematuria. UmiRNAs could serve as therapeutic targets or recurrence markers of non-muscle-invasive BC and could predict the aggressivity and prognosis of muscle-invasive BC. In renal cell carcinoma, miRNAs have been identified as predictors of tumor detection, aggressiveness, and progression to metastasis. UmiRNAs could play an important role in the diagnosis, prognosis, and therapy of urological cancers.

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Section: Resultsmentioning

confidence: 99%

Urinary MicroRNAs as Biomarkers of Urological Cancers: A Systematic Review

Aveta

Cilio

Contieri

et al. 2023

IJMS

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“…Furthermore, changes in the dimensions of an SRM during thermal ablation also contribute to predicting the likelihood of LTP [13,62]. As the RCC shrinks, there is a reduction in the probability of local recurrence, owing to the decreased number of viable tumor cells.…”

Section: Imaging In Post-ablative Techniques Follow-up: Strategies An...mentioning

confidence: 99%

Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review

Aveta,

Iossa,

Spena

et al. 2024

Life

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This review focuses on ablative techniques for small renal masses (SRMs), including radiofrequency ablation (RFA), cryoablation (CA), microwave ablation (MWA), and irreversible electroporation (IRE), and discusses recurrence management. Through an extensive literature review, we outline the procedures, outcomes, and follow-up strategies associated with each ablative method. The review provides a detailed examination of these techniques—RFA, CA, MWA, and IRE—elucidating their respective outcomes. Recurrence rates vary among them, with RFA and CA showing comparable rates, MWA demonstrating favorable short-term results, and IRE exhibiting promise in experimental stages. For managing recurrences, various strategies are considered, including active surveillance, re-ablation, or salvage surgery. Surveillance is preferred post-RFA and post-CA, due to slow SRM growth, while re-ablation, particularly with RFA and CA, is deemed feasible without additional complications. Salvage surgery emerges as a viable option for larger or resistant tumors. While ablative techniques offer short-term results comparable to surgery, further research is essential to understand their long-term effects fully. Decisions concerning recurrence management should consider individual and tumor-specific factors. Imaging, notably contrast-enhanced ultrasounds, plays a pivotal role in assessing treatment success, emphasizing the necessity of a multidisciplinary approach for optimal outcomes. The lack of randomized trials highlights the need for further research.

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“…CARMENA’s findings suggest that sunitinib alone might be superior to the combination of CN followed by sunitinib, challenging the necessity of CN in all mRCC cases. SURTIME explored the timing of CN, suggesting potential benefits of deferred CN after systemic therapy in certain patient subsets [ 6 , 7 ], and this finding has challenged the paradigm of CN [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Cytoreductive Nephrectomy in Select Primary Metastatic Renal Cell Carcinoma Patients: A Comprehensive Nationwide Outcome Analysis

Azawi,

Geertsen,

Nadler

et al. 2024

Cancers

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(1) Background: The role of cytoreductive nephrectomy (CN) is controversial in patients with primary metastatic renal cell carcinoma (mRCC). (2) Methods: We evaluated the impact of CN, or no CN, followed by first-line targeted therapy (TT) in a nationwide unselected cohort of 437 consecutive patients with primary mRCC over a two-year period with a minimum of five years of follow-up. Data sources were national registries supplemented with manually extracted information from individual patient medical records. Cox proportional hazards estimated the hazard ratio (HR) of overall death and cancer-specific death after one and three years. (3) Results: 210 patients underwent CN and 227 did not. A total of 176 patients (40%) had CN followed by TT, 160 (37%) had TT alone, 34 (8%) underwent CN followed by observation, and 67 (15%) received no treatment. After adjustments in Model 2, patients treated with TT alone demonstrated a worsened overall survival (OS) compared to those treated with CN + TT, HR 0.63 (95% CI: 0.19–2.04). (4) Conclusions: In this nationwide study, CN was associated with enhanced outcomes in carefully selected patients with primary mRCC. Further randomized trials are warranted.

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Cytoreductive Nephrectomy and Metastatic Renal Cell Carcinoma: State of the Art and Future Perspectives

Cited by 12 publications

References 50 publications

Urinary MicroRNAs as Biomarkers of Urological Cancers: A Systematic Review

Urinary MicroRNAs as Biomarkers of Urological Cancers: A Systematic Review

Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review

Cytoreductive Nephrectomy in Select Primary Metastatic Renal Cell Carcinoma Patients: A Comprehensive Nationwide Outcome Analysis

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