878 - The role of nephrectomy in metastatic renal cell carcinoma - a single centre analysis

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Renal Cell Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Joana Neves
Authors J. Neves1, I. Fernandes2, J.T.M.L. Ribeiro2, D. Macedo3, L. Costa4
  • 1University of Lisbon, 1649 - Lisbon/PT
  • 2Oncology Division, Santa Maria Hospital(HSM-CHLN), PT-1649-035 - Lisbon/PT
  • 3Oncology Division, Santa Maria Hospital(HSM-CHLN), Lisbon/PT
  • 4Oncology, Santa Maria Hospital(HSM-CHLN), PT-1649-035 - Lisbon/PT

Abstract

The approval of new therapeutic options has increased the survival of metastatic renal cell carcinoma (mRCC) patients (pts). These drugs were mostly studied in pts who underwent nephrectomy (Sx) prior to the diagnosis of metastatic disease (MD). Sx is also indicated for pts with MD who are suitable and have good performance status (PS). The aim of this work is to retrospectively analyse the benefit of Sx in the pts with mRCC referred to the Oncology Division at Santa Maria Hospital from 01/2006 to 10/2010. Two groups of pts were defined: pts who had Sx and pts who had no Sx. The first group was further divided into pts who had Sx whilst with non-MD (SxNMD) and pts who did it whilst with MD (SxMD). With significance set at p = 0.05 and the aid of IBM® SPSS® Statistics 20, statistical analysis was performed using descriptive statistics and Fisher's exact test. Overall survival (OS) - time from diagnosis of MD to death - was plotted using the Kaplan–Meier method and compared by log-rank test. The population had 44 pts: 72,7% (n = 32) male, 59,1% (n = 26) under 65 years old, 90,9% (n = 40) with Karnofsky PS (KPS) ≥80 and 59,1% (n = 26) with clear cell carcinoma. Half were diagnosed with non-MD (NMD) (n = 22) and progressed to MD in a mean of 45,9 months (m). Thirty-eight pts (86,4%) did medical therapy, of those 86,8% (n = 33) had favourable or intermediate risk according to the Memorial Sloan Kettering Cancer Center (MSKCC) criteria and 86,8% (n = 33) did target therapy. Thirty pts underwent Sx (68,2%) and 14 didn't (31,8%). There was no statistical difference between groups regarding gender, age, KPS, histology, MSKCC risk and medical therapy. The median OS was 14 and 27 m respectively for the no Sx group versus the Sx group (p = 0,027). In the pts who had Sx, 21 (70%) were part of the SxNMD group and 9 (30%) of the SxMD group. Except for Fuhrman grade (p = 0,022), there was no statistical difference between groups regarding gender, age, KPS, histology, MSKCC risk and medical therapy. The median OS for SxNMD had not been reached while the median OS for SxMD was 21 m (p = 0,682). In the population studied there was no difference in OS curves between the SxNMD group and the SxMD group. This suggests that Sx has a valuable role in pts diagnosed with MD in addition to medical therapy, namely target therapy.

Disclosure

All authors have declared no conflicts of interest.