TY - JOUR
T1 - Effect of renal embolization in patients with synchronous metastatic renal cell carcinoma
T2 - A retrospective comparison of cytoreductive nephrectomy and systemic medical therapy
AU - Kim, Sung Han
AU - Kim, Jung Kwon
AU - Park, Boram
AU - Joo, Jungnam
AU - Joung, Jae Young
AU - Seo, Ho Kyung
AU - Lee, Kang Hyun
AU - Chung, Jinsoo
N1 - Publisher Copyright:
© Kim et al.
PY - 2017
Y1 - 2017
N2 - Objective: To compare survival outcomes for renal embolization (RE) to cytoreductive nephrectomy (CN) and no primary renal treatment (NT) among patients with synchronous metastatic renal cell carcinoma (mRCC) treated using either targeted therapy (TT) or immunotherapy (IT). Results: The median follow-up duration was 81.3 months, with a duration of first-line treatment of 3.5 months. Among the 211 patients, the median PFS and OS were 4.4 and 10.6 months. Specifically for patients receiving TT (124 patients), the PFS and OS were 5.5 and 12.0 months. An intervention effect was identified only for OS, with a median OS of 20.1, 8.8 and 9.3 months for CN, RE and NT, respectively. After stratification by risk classification, CN provided a significant benefit on OS, compared to RE and NT, for patients with an intermediate risk (MSKCC). For those with a poor risk (Heng criteria), NT provided better survival than PFS (p=0.003), and a comparable survival to RE (p > 0.05). Materials and Methods: Retrospective analysis of 211 patients, 87 treated with IT and 124 with TT, retrieved from our RCC database. Patients' risk factors for survival was evaluated using the Heng and MSKCC criteria, with only patients with an intermediate or poor survival risk included in the analysis. Between-group comparisons were evaluated with respect to progression-free survival (PFS) and overall survival (OS). Conclusions: The differential effect of CN and RE on OS appears to be modulated by risk classification. In patients with a poor risk, RE should be implemented after careful consideration of comorbidities and life expectancy.
AB - Objective: To compare survival outcomes for renal embolization (RE) to cytoreductive nephrectomy (CN) and no primary renal treatment (NT) among patients with synchronous metastatic renal cell carcinoma (mRCC) treated using either targeted therapy (TT) or immunotherapy (IT). Results: The median follow-up duration was 81.3 months, with a duration of first-line treatment of 3.5 months. Among the 211 patients, the median PFS and OS were 4.4 and 10.6 months. Specifically for patients receiving TT (124 patients), the PFS and OS were 5.5 and 12.0 months. An intervention effect was identified only for OS, with a median OS of 20.1, 8.8 and 9.3 months for CN, RE and NT, respectively. After stratification by risk classification, CN provided a significant benefit on OS, compared to RE and NT, for patients with an intermediate risk (MSKCC). For those with a poor risk (Heng criteria), NT provided better survival than PFS (p=0.003), and a comparable survival to RE (p > 0.05). Materials and Methods: Retrospective analysis of 211 patients, 87 treated with IT and 124 with TT, retrieved from our RCC database. Patients' risk factors for survival was evaluated using the Heng and MSKCC criteria, with only patients with an intermediate or poor survival risk included in the analysis. Between-group comparisons were evaluated with respect to progression-free survival (PFS) and overall survival (OS). Conclusions: The differential effect of CN and RE on OS appears to be modulated by risk classification. In patients with a poor risk, RE should be implemented after careful consideration of comorbidities and life expectancy.
KW - Embolization
KW - Metastasis
KW - Nephrectomy
KW - Renal cell carcinoma
KW - Synchronous
UR - http://www.scopus.com/inward/record.url?scp=85025817388&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.17865
DO - 10.18632/oncotarget.17865
M3 - Article
C2 - 28548948
AN - SCOPUS:85025817388
SN - 1949-2553
VL - 8
SP - 49615
EP - 49624
JO - Oncotarget
JF - Oncotarget
IS - 30
ER -
