University of Oulu

Laru, L., Ronkainen, H., Ohtonen, P. et al. Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status—results from a Finnish nation-wide population-based study from 2005 to 2010. World J Surg Onc 19, 190 (2021).

Nephrectomy improves the survival of metastatic renal cell cancer patients with moderate to good performance status : results from a Finnish nation-wide population-based study from 2005 to 2010

Saved in:
Author: Laru, Lauri1,2; Ronkainen, Hanna1; Ohtonen, Pasi3;
Organizations: 1Department of Surgery, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Department of Urology, Oulu University Hospital, PO Box 21, FI-90029 OYS, Oulu, Finland
3Division of Operative Care, Oulu University Hospital and Medical Research Center Oulu, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Springer Nature, 2021
Publish Date: 2021-10-07


Background: The purpose of this study was to evaluate the effects of cytoreductive nephrectomy (CN) and metastasectomies on the survival of patients with synchronous metastatic renal cell cancer (mRCC) using real-life, population-based national dataset.

Methods: Nationwide data, including all cases of synchronous mRCC in Finland diagnosed on a 6-year timeframe, based on the Finnish Cancer Registry and complemented with patient records from the treating hospitals, were analyzed. Patients with Eastern Cooperative Oncology Group (ECOG) performance status 3–4 were excluded. Univariate and adjusted multivariable survival analysis were performed, including subgroup analysis for patients with different medical therapies. Nephrectomy complications were also analyzed.

Results: A total of 732 patients were included in the analysis. CN was performed for 389 (53.1%) patients, whereas 68 (9.3%) patients underwent nephrectomy and metastasectomies of all lesions (surgery with curative intent). Median overall survival (OS) for patients who did not undergo nephrectomy was 5.9 (95% confidence interval [CI] = 4.6–7.2) months. Patients who had a CN had a median OS of 16.6 (95% CI = 14.2–19.1, p < 0.001) months, whereas patients who had surgery with curative intent had a median OS of 51.3 (95% CI = 36.0–66.6, p < 0.001) months. The survival benefit of CN and metastasectomies remained significant in all medical therapy subgroups and in both of the applied multivariable statistical models.

Conclusions: Surgical treatment of metastatic renal cell cancer is associated with a significant survival benefit in patients with good and moderate performance status, regardless of the chosen medical therapy.

see all

Series: World journal of surgical oncology
ISSN: 1477-7819
ISSN-E: 1477-7819
ISSN-L: 1477-7819
Volume: 19
Issue: 1
Article number: 190
DOI: 10.1186/s12957-021-02308-0
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
Funding: This work was supported in part by the Finnish Urological Association to Lauri Laru.
Copyright information: © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.