Overall survival in patients with metastatic renal cell carcinoma and clinical N1 disease undergoing cytoreductive nephrectomy and lymph node dissection

Faiena, Izak; Salmasi, Amirali; Donin, Nicholas M.; Johnson, David C.; Bachour, Kinan; Drakaki, Alexandra; Belldegrun, Arie S.; Chamie, Karim

doi:10.1016/j.urolonc.2017.10.009

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…Central nervous system metastases were associated with the worst prognosis, as patients in this group had a 5-year survival rate of only 18% [ 23 ]. A study [ 54 ] on a population of 1780 patients with clinically positive lymph nodes showed that their excision improved OS by 3% for each node excised; however, this group of patients is at lower risk of survival due to other comorbid factors.…”

Section: Resultsmentioning

confidence: 99%

Surgical Approach in Metastatic Renal Cell Carcinoma: A Literature Review

Matuszczak

Kiljańczyk

Salagierski

2023

Cancers

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Section: Resultsmentioning

confidence: 99%

Surgical Approach in Metastatic Renal Cell Carcinoma: A Literature Review

Matuszczak

Kiljańczyk

Salagierski

2023

Cancers

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“…This may be due to the lymph node dissection performed during CRN. Increasing lymph node yield on the pathologic specimen is associated with improved OS in patients with mRCC and N1 disease who underwent cytoreductive nephrectomy ( 27 ). Although lymph node dissection did not improve OS in mRCC in many studies, the N stage should not be simply divided into N0 and N1 as in the current TNM stage, which is in line with the new EAU RCC TNM staging system ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Establishment and validation of a nomogram to select patients with metastatic sarcomatoid renal cell carcinoma suitable for cytoreductive radical nephrectomy

Zhou,

Gu,

Tang

et al. 2023

Front. Oncol.

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IntroductionMetastatic renal cell carcinoma (mRCC) with sarcomatoid features has a poor prognosis. Cytoreductive radical nephrectomy (CRN) can improve prognosis, but patient selection is unclear. This study aimed to develop a prediction model for selecting patients suitable for CRN.Materials and methodsPatients with a diagnosis of mRCC with sarcomatoid features in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 were retrospectively reviewed. CRN benefit was defined as a survival time longer than the median overall survival (OS) in patients who did not receive CRN. A prediction nomogram was established and validated using the SEER cohort (training and internal validation) and an external validation cohort.ResultsOf 900 patients with sarcomatoid mRCC, 608 (67.6%) underwent CRN. OS was longer in the CRN group than in the non-CRN group (8 vs. 6 months, hazard ratio (HR) = 0.767, p = 0.0085). In the matched CRN group, 124 (57.7%) patients survived >6 months after the surgery and were considered to benefit from CRN. Age, T-stage, systematic therapy, metastatic site, and lymph nodes were identified as independent factors influencing OS after CRN, which were included in the prediction nomogram. The monogram performed well on the training set (area under the receiver operating characteristic (AUC) curve = 0.766, 95% confidence interval (CI): 0.687–0.845), internal validation set (AUC = 0.796, 95% CI: 0.684–0.908), and external validation set (AUC = 0.911, 95% CI: 0.831–0.991).ConclusionsA nomogram was constructed and validated with good accuracy for selecting patients with sarcomatoid mRCC suitable for CRN.

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“…In addition, the modern phase III trials have not mandated LND as a component of CN [3,4,48]. Nonetheless, five retrospective observational studies and one meta-analysis have investigated whether LND during CN is associated with an improvement in overall survival among patients with mRCC [55][56][57][58][59][60]. The common finding between these studies is that LND does not appear to impart a survival advantage in mRCC patients.…”

Section: Is There a Role For Concomitant Regional Lymph Node Dissection During Cytoreductive Nephrectomy?mentioning

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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Overall survival in patients with metastatic renal cell carcinoma and clinical N1 disease undergoing cytoreductive nephrectomy and lymph node dissection

Cited by 6 publications

References 18 publications

Surgical Approach in Metastatic Renal Cell Carcinoma: A Literature Review

Surgical Approach in Metastatic Renal Cell Carcinoma: A Literature Review

Establishment and validation of a nomogram to select patients with metastatic sarcomatoid renal cell carcinoma suitable for cytoreductive radical nephrectomy

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

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