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). https://doi.org/10.1186/s12957-021-02308-0

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

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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: http://urn.fi/urn:nbn:fi-fe2021100750173
Language: English
Published: Springer Nature, 2021
Publish Date: 2021-10-07
Description:

Abstract

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.

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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
OADOI: https://oadoi.org/10.1186/s12957-021-02308-0
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
Subjects:
Funding: This work was supported in part by the Finnish Urological Association to Lauri Laru.
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