Although novel targeted and immunotherapy-based medications have led to substantially improved survival of patients with metastatic clear cell renal cell carcinoma (RCC) in recent years, partial vs radical cytoreductive nephrectomy continues to offer reduced mortality from causes other than the cancer, investigators reported at the 38th Annual Congress of the European Association of Urology (EAU23) in Milan, Italy.
In their study of 5149 patients, the 5-year rates of cancer-related death associated with partial and radical cytoreductive nephrectomy for metastatic clear cell RCC did not differ significantly (50.8% and 53.6%, respectively), but the 5-year rates of other-cause mortality (OCM) were significantly lower among patients treated with partial cytoreductive nephrectomy (2.4% and 7.5%, respectively), after propensity score-matching.
On multivariable analysis, partial nephrectomy was significantly associated with a 54% lower risk for OCM compared with radical nephrectomy, Cristina Cano Garcia, MD, of the University of Montreal Health Center in Quebec, Canada, reported.
As a result of their findings, Dr Garcia concluded, partial cytoreductive nephrectomy should still be considered a “valuable alternative” to radical cytoreductive nephrectomy when technically feasible.
Dr Garcia and colleagues identified their study population using the Surveillance, Epidemiology and End Results (SEER) database (2004-2019). Of the 5149 patients, 237 (5%) underwent partial nephrectomy and 4912 (95%) underwent radical nephrectomy. Patients had a median follow-up duration of 22 months. From this group, the investigators created a propensity score-matched study cohort of 237 patients in each treatment arm. They matched patients by age, sex, year of diagnosis, race or ethnicity, grade group, tumor size, T-stage, and N-stage.
Cano Carcia C, Flammia RS, Piccinelli M, et al. Differences in survival of clear cell metastatic renal cell carcinoma patients according to partial vs. radical nephrectomy. Presented at: EAU23, Milan, Italy, March 10-13, 2023. Abstract A0328.