|The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.|
CHICAGO—Complete surgical resection of metastases from renal cell carcinoma (RCC) is associated with improved survival in the era of contemporary systemic therapy, according to new study findings presented at the 2019 American Urological Association annual meeting.
In a study of 586 patients who underwent radical or partial nephrectomy for unilateral RCC whose first occurrence of distant metastases occurred between 2006 and 2017, complete metastasectomy (CM) was associated with a significant 59% decreased risk of RCC-related death and 59% decreased risk of death from any cause, after adjusting for age, sex, and the timing, number, and location of metastases.
“Complete metastasectomy is associated with a survival advantage for patients with metastatic renal cell carcinoma, and is endorsed by clinical practice guidelines,” lead investigator Timothy D. Lyon, MD, of Mayo Clinic and Rochester, Minnesota, told Renal & Urology News. “However, the majority of existing data supporting CM are derived from the cytokine era, and whether CM remains associated with improved survival with the availability of more recently approved systemic therapies, including targeted therapy and checkpoint inhibitors, has not been well described … These data suggest that CM should continue to be offered to appropriately selected patients despite the availability of more effective systemic therapies.”
Of the 586 patients, 158 underwent CM, defined as complete surgical resection of all index sites of metastases. During a median post-diagnosis follow-up of 3.9 years, 403 patients died, including 345 from RCC, Dr Lyon and his collaborators reported in a poster presentation.
Of the CM patients, 147 (93%) did not require systemic therapy for their index metastatic lesions. The 2-year cancer-specific survival rate was significantly greater in the CM than no-CM group (84% vs 54%).
He and his colleagues acknowledged various study limitations, including selection bias due to nonrandomized treatment allocation, no assessment of comorbidity or functional status at the time of metastasis, and the use of data from a single institution.
Read more of Renal & Urology News’ coverage of the AUA 2019 meeting by visiting the conference page.
Lyon T, Thompson RH, Lohse C, et al. Complete metastasectomy for renal cell carcinoma in the contemporary era. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract MP25-06.