Surgery may improve survival for patients who receive targeted therapies for metastatic renal cell cancer, according to a study by researchers at Dana-Farber Cancer Institute and Brigham and Women’s Hospital (Boston, MA).
While most clinical guidelines still recommend the use of cytoreductive nephrectomy (CN), the complete removal of the kidney when cancer has spread to distant parts of the body in patients with renal cancer, the introduction of molecularly targeted agents have obscured how the procedure should be used in conventional practice.
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Therefore, researchers co-lead by Maxine Sun, PhD, and Nawar Hanna, MD, Dana-Farber and Brigham and Women’s, conducted a study evaluating the utilization rates of CN and how use of the technique changed survival in patients receiving targeted therapies for metastatic renal cancer.
Using the National Cancer Data Base, researchers identified 15,390 patients who received targeted therapies for the treatment of renal cancer between 2006 and 2013. A total of 5374 (35%) patients underwent CN, and those who were younger, privately insured, treated at academic centers, and with a lower tumor stage were more likely to undergo CN.
Overall, patients who received CN survived for a median period of 17.1 months compared with 7.7 months in those who did not undergo CN. Additionally, sensitivity analyses revealed that patients who received CN had a lower risk of death than those who did not.
Researchers concluded that CN is only performed in 3 of 10 patients with metastatic renal cell carcinoma who are receiving targeted therapies. CN may also offer overall survival benefit in some patients with metastatic renal cell cancer, indicating a need for more intensive screening to identify patients most likely to benefit.
“The study underscores the importance of careful selection of patients who are good candidates for this surgery,” said Dr Sun. “As we become better able to identify patients likely to derive the greatest benefit from surgery, survival rates may further improve.”
