Larger tumor size is an independent risk factor for poor survival after cytoreductive nephrectomy (CN) for renal cell carcinoma (RCC), investigators reported at the 22nd annual meeting of the Society of Urologic Oncology
Among 360 patients (28% female; mean age 61 years) within the 2005-2019 International Marker Consortium for Renal Cancer (INMARC) who received CN and systemic therapy, primary clinical tumor size was 7 cm or greater in 249 patients (69.2%). During follow-up, 218 patients died (61%), including 50 (13.9%) from RCC.
In multivariable analyses, clinical tumor size of 7 cm or greater was significantly associated with 2.6- and 1.5-fold increased risks for cancer-specific mortality and all-cause mortality, respectively, Ryan Isaac Nasseri, MD, of the University of California, San Diego, reported in a poster presentation on behalf of his team. Hypertension was significantly associated with a 3.7-fold increased risk for cancer-specific mortality. Papillary RCC was significantly associated with 76% decreased risk for death from RCC.
Management of metastatic RCC “is in the process of a dramatic evolution with the proliferation of systemic agents and reassessment of the role of cytoreductive surgery,” Dr Nasseri and colleagues noted.
The authors concluded, “Further investigation is necessary to confirm our findings and to delineate the mechanisms responsible for this phenomenon.”
Nasseri RI, Master V, Fujii Y, et al. Impact of tumor size on survival in patients undergoing cytoreductive nephrectomy for renal cell carcinoma: analysis from the international marker consortium for renal cancer [INMARC]. Presented at the 22nd annual meeting of the Society of Urologic Oncology. December 1-3, 2021. Poster 164.