&lt;p&gt;The Effect of Cytoreductive Partial Nephrectomy in Elderly Patients with Metastatic Renal Cell Carcinoma&lt;/p&gt;

Chen, Jiabi; He, Qingliu; Liu, Weihui; Li, Yining; Zhuang, Wei

doi:10.2147/cia.s243902

Cited by 11 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nomogram is a data-based graphical computing tool that can estimate the risk of developing a disease based on staging systems, such as the American Joint Commission on Cancer (AJCC) and other key risk factors related to prognosis ( 42 ). Today, many kinds of nomograms have been developed and applied to RCC, such as Chen et al ( 43 ), who included 6,105 elderly patients with metastatic RCC in the SEER database from 2010 to 2015, indicating the advantages of PN in elderly mRCC. Michele et al ( 44 ) included 4,541 patients with RCC over 75 years of age in the SEER database from 2004 to 2014 and proved that PN did not increase the mortality of elderly patients.…”

Section: Discussionmentioning

confidence: 99%

A Web-Based Prediction Model for Cancer-Specific Survival of Elderly Patients With Clear Cell Renal Cell Carcinoma: A Population-Based Study

Zhanghuang

Wang

Zhang

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

BackgroundClear cell renal cell carcinoma (ccRCC) is expected in the elderly and poor prognosis. We aim to explore prognostic factors of ccRCC in the elderly and construct a nomogram to predict cancer-specific survival (CSS) in elderly patients with ccRCC.MethodsClinicopathological information for all elderly patients with ccRCC from 2004 to 2018 was downloaded from the Surveillance, Epidemiology, and End Results (SEER) program. All patients were randomly assigned to a training cohort (70%) or a validation cohort (30%). Univariate and multivariate Cox regression models were used to identify the independent risk factors for CSS. A new nomogram was constructed to predict CSS at 1-, 3-, and 5 years in elderly patients with ccRCC based on independent risk factors. Subsequently, we used the consistency index (C-index), calibration curves, and the area under the receiver operating curve (AUC) and decision curve analysis (DCA) to test the prediction accuracy of the model.ResultsA total of 33,509 elderly patients with ccRCC were enrolled. Univariate and multivariate Cox regression analyses results showed that age, sex, race, marriage, tumor size, histological grade, tumor, nodes, and metastases (TNM) stage, and surgery were independent risk factors for CSS in elderly patients with ccRCC. We constructed a nomogram to predict CSS in elderly patients with ccRCC. The C-index of the training cohort and validation cohort was 0.81 (95% CI: 0.802–0.818) and 0.818 (95% CI: 0.806–0.830), respectively. The AUC of the training cohort and validation cohort also suggested that the prediction model had good accuracy. The calibration curve showed that the observed value of the prediction model was highly consistent with the predicted value. DCA showed good clinical application value of the nomogram.ConclusionIn this study, we explored prognostic factors in elderly patients with ccRCC. We found that age, sex, marriage, TNM stage, surgery, and tumor size were independent risk factors for CSS. We constructed a new nomogram to predict CSS in elderly patients with ccRCC with good accuracy and reliability, providing clinical guidance for patients and physicians.

show abstract

Section: Discussionmentioning

confidence: 99%

A Web-Based Prediction Model for Cancer-Specific Survival of Elderly Patients With Clear Cell Renal Cell Carcinoma: A Population-Based Study

Zhanghuang

Wang

Zhang

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…However, when they stratified the data by tumor size, they found this benefit to be isolated to small renal tumors (less than 4 cm). Chen et al 13 also showed survival advantage of patient who underwent cPN versus cRN. After subgroup analysis they also confirmed that OS was superior only in male patients with ⩽7 cm tumor, N0 and isolated metastasis and even in the N1 stage, cPN results was worse than cRN.…”

Section: Table 2 Quality Assessment Items and Possible Scoresmentioning

confidence: 92%

Comparison of cytoreductive partial versus radical nephrectomy in metastatic renal cell carcinoma: To be on the horns of a dilemma

et al. 2022

View full text Add to dashboard Cite

Background: Cytoreductive radical nephrectomy (cRN) with immunotherapy is the treatment of choice in patients with metastatic renal cell carcinoma (mRCC). Limited data are available on the role of cytoreductive partial nephrectomy (cPN) in mRCC. This study is a systematic review and meta-analysis of the evidence regarding survival rates comparing cPN versus cRN. Methods: PubMed/Medline, Scopus, Google Scholar, EMBASE, and the Cochrane Library were reviewed in December 2021 according to PRISMA. Four articles including 2669 patients were selected to enroll in the study. The identified reports were reviewed and their methodological quality was subjected to total quality assessment. The outcomes were cancer specific survival (CSS) and overall survival rate (OS). Results: Totally 2669 patients, 542 in cPN and 2127 in cRN groups enrolled in final analysis. Of the preoperative data, there were significant differences in preoperative size of tumor between cRN and cPN patients ( p < 0.001), however Fuhrman grades were comparable between groups (low grade: p = 0.51, high grade: p = 0.76). There were comparable results in 1-year ( p = 0.07), 2-year ( p = 0.08), and 3-year ( p = 0.71) CSS rates between cPN versus cRN. There was no significant difference between cPN versus cRN in OS rate ( p = 0.61). Conclusion: There are comparable results between cPN and cRN in CSS and OS rate. However, due to a lack of data, future study will need to do more extensive studies using prospectively recorded patient features to evaluate the cPN and cRN in the metastatic setting.

show abstract

“…Data from the SEER database and the National Cancer Database (NCDB) show a PN rate of 4.2% and 3.8%, respectively [82,83]. PN did not show inferior oncological outcomes compared to radical nephrectomy (RN) in four studies [82,[84][85][86] and was, on the contrary, associated with better outcomes in three published sets [9,82,87]. The rate of early (30 days) complications in PN in solitary kidneys was higher compared to RN (33% vs. 10%, p = 0.009) [86].…”

Section: Surgical Aspects Of Cytoreductive Nephrectomymentioning

confidence: 94%

The Evolving Landscape of Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma

Studentova,

Spisarova,

Kopova

et al. 2023

Cancers

View full text Add to dashboard Cite

The role of cytoreductive nephrectomy in metastatic renal cell carcinoma (RCC) has been studied intensively over the past few decades. Interestingly, the opinion with regard to the importance of this procedure has switched from a recommendation as a standard of care to an almost complete refutation. However, no definitive agreement on cytoreductive nephrectomy, including the pros and cons of the procedure, has been reached, and the topic remains highly controversial. With the advent of immune checkpoint inhibitors, we have experienced a paradigm shift, with immunotherapy playing a crucial role in the treatment algorithm. Nevertheless, obtaining results from prospective clinical trials on the role of cytoreductive nephrectomy requires time, and once some data have been gathered, the standards of systemic therapy may be different, and we stand again at the beginning. This review summarizes current knowledge on the topic in the light of newly evolving treatment strategies. The crucial point is to recognize who could be an appropriate candidate for immediate cytoreductive surgery that may facilitate the effect of systemic therapy through tumor debulking, or who might benefit from deferred cytoreduction in the setting of an objective response of the tumor. The role of prognostic factors in management decisions as well as the technical details associated with performing the procedure from a urological perspective are discussed. Ongoing clinical trials that may bring new evidence for transforming therapeutic paradigms are listed.

show abstract

<p>The Effect of Cytoreductive Partial Nephrectomy in Elderly Patients with Metastatic Renal Cell Carcinoma</p>

Cited by 11 publications

References 24 publications

A Web-Based Prediction Model for Cancer-Specific Survival of Elderly Patients With Clear Cell Renal Cell Carcinoma: A Population-Based Study

A Web-Based Prediction Model for Cancer-Specific Survival of Elderly Patients With Clear Cell Renal Cell Carcinoma: A Population-Based Study

Comparison of cytoreductive partial versus radical nephrectomy in metastatic renal cell carcinoma: To be on the horns of a dilemma

The Evolving Landscape of Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma

Contact Info

Product

Resources

About