Does timing of cytoreductive nephrectomy impact patient survival with metastatic renal cell carcinoma in the tyrosine kinase inhibitor era? A multi-institutional study

Sean P. Stroup, Omer A. Raheem, Kerrin L. Palazzi, Michael A. Liss, Reza Mehrazin, Ryan Kopp, Nishant Patel, Seth A. Cohen, Samuel K. Park, Anthony L. Patterson, Christopher J. Kane, Frederick Millard, Ithaar H. Derweesh

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Abstract

Objective: To compare outcomes of metastatic renal cell carcinoma (mRCC) patients who underwent primary cytoreductive nephrectomy (CRN), followed by adjuvant sunitinib therapy, vs those who underwent primary sunitinib therapy before planned CRN. Methods: This was a multi-institutional retrospective analysis of 35 mRCC patients from June 2005 to August 2009 (median follow-up, 28.5 months): 17 underwent primary CRN, followed by adjuvant sunitinib (group 1); 18 underwent primary sunitinib therapy, followed by planned CRN (group 2). Response to therapy was determined using Response Evaluation Criteria in Solid Tumors. Group 2 patients who had partial response (PR)/stable disease (SD) proceeded to CRN (group 2 +CRN). Group 2 patients who progressed were treated with salvage systemic therapy (group 2 no-CRN). Primary and secondary outcomes were disease-specific survival (DSS) and overall survival (OS). Results: Patient demographic and tumor characteristics were similar. The groups had similar rates of DSS and OS on univariate analysis (P =.318 and P =.181). In group 2, 11 (61%) had PR/DS; 7 (39%) progressed. Mean times to disease-specific death in group 1, group 2 (+CRN), and group 2 (no-CRN) were 29.2, 4.6, and 28.7 months, respectively (P =.025). Kaplan-Meier analysis of DSS and OS demonstrated significant improvement in group 2 (+CRN) vs group 1 vs group 2 (no-CRN; P

Original languageEnglish (US)
Pages (from-to)805-811
Number of pages7
JournalUrology
Volume81
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

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Nephrectomy
Renal Cell Carcinoma
Protein-Tyrosine Kinases
Survival
Salvage Therapy
Kaplan-Meier Estimate
Therapeutics
Demography
sunitinib

ASJC Scopus subject areas

  • Urology

Cite this

Does timing of cytoreductive nephrectomy impact patient survival with metastatic renal cell carcinoma in the tyrosine kinase inhibitor era? A multi-institutional study. / Stroup, Sean P.; Raheem, Omer A.; Palazzi, Kerrin L.; Liss, Michael A.; Mehrazin, Reza; Kopp, Ryan; Patel, Nishant; Cohen, Seth A.; Park, Samuel K.; Patterson, Anthony L.; Kane, Christopher J.; Millard, Frederick; Derweesh, Ithaar H.

In: Urology, Vol. 81, No. 4, 04.2013, p. 805-811.

Research output: Contribution to journalArticle

Stroup, SP, Raheem, OA, Palazzi, KL, Liss, MA, Mehrazin, R, Kopp, R, Patel, N, Cohen, SA, Park, SK, Patterson, AL, Kane, CJ, Millard, F & Derweesh, IH 2013, 'Does timing of cytoreductive nephrectomy impact patient survival with metastatic renal cell carcinoma in the tyrosine kinase inhibitor era? A multi-institutional study', Urology, vol. 81, no. 4, pp. 805-811. https://doi.org/10.1016/j.urology.2012.10.054
Stroup, Sean P. ; Raheem, Omer A. ; Palazzi, Kerrin L. ; Liss, Michael A. ; Mehrazin, Reza ; Kopp, Ryan ; Patel, Nishant ; Cohen, Seth A. ; Park, Samuel K. ; Patterson, Anthony L. ; Kane, Christopher J. ; Millard, Frederick ; Derweesh, Ithaar H. / Does timing of cytoreductive nephrectomy impact patient survival with metastatic renal cell carcinoma in the tyrosine kinase inhibitor era? A multi-institutional study. In: Urology. 2013 ; Vol. 81, No. 4. pp. 805-811.
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abstract = "Objective: To compare outcomes of metastatic renal cell carcinoma (mRCC) patients who underwent primary cytoreductive nephrectomy (CRN), followed by adjuvant sunitinib therapy, vs those who underwent primary sunitinib therapy before planned CRN. Methods: This was a multi-institutional retrospective analysis of 35 mRCC patients from June 2005 to August 2009 (median follow-up, 28.5 months): 17 underwent primary CRN, followed by adjuvant sunitinib (group 1); 18 underwent primary sunitinib therapy, followed by planned CRN (group 2). Response to therapy was determined using Response Evaluation Criteria in Solid Tumors. Group 2 patients who had partial response (PR)/stable disease (SD) proceeded to CRN (group 2 +CRN). Group 2 patients who progressed were treated with salvage systemic therapy (group 2 no-CRN). Primary and secondary outcomes were disease-specific survival (DSS) and overall survival (OS). Results: Patient demographic and tumor characteristics were similar. The groups had similar rates of DSS and OS on univariate analysis (P =.318 and P =.181). In group 2, 11 (61{\%}) had PR/DS; 7 (39{\%}) progressed. Mean times to disease-specific death in group 1, group 2 (+CRN), and group 2 (no-CRN) were 29.2, 4.6, and 28.7 months, respectively (P =.025). Kaplan-Meier analysis of DSS and OS demonstrated significant improvement in group 2 (+CRN) vs group 1 vs group 2 (no-CRN; P",
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AU - Stroup, Sean P.

AU - Raheem, Omer A.

AU - Palazzi, Kerrin L.

AU - Liss, Michael A.

AU - Mehrazin, Reza

AU - Kopp, Ryan

AU - Patel, Nishant

AU - Cohen, Seth A.

AU - Park, Samuel K.

AU - Patterson, Anthony L.

AU - Kane, Christopher J.

AU - Millard, Frederick

AU - Derweesh, Ithaar H.

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N2 - Objective: To compare outcomes of metastatic renal cell carcinoma (mRCC) patients who underwent primary cytoreductive nephrectomy (CRN), followed by adjuvant sunitinib therapy, vs those who underwent primary sunitinib therapy before planned CRN. Methods: This was a multi-institutional retrospective analysis of 35 mRCC patients from June 2005 to August 2009 (median follow-up, 28.5 months): 17 underwent primary CRN, followed by adjuvant sunitinib (group 1); 18 underwent primary sunitinib therapy, followed by planned CRN (group 2). Response to therapy was determined using Response Evaluation Criteria in Solid Tumors. Group 2 patients who had partial response (PR)/stable disease (SD) proceeded to CRN (group 2 +CRN). Group 2 patients who progressed were treated with salvage systemic therapy (group 2 no-CRN). Primary and secondary outcomes were disease-specific survival (DSS) and overall survival (OS). Results: Patient demographic and tumor characteristics were similar. The groups had similar rates of DSS and OS on univariate analysis (P =.318 and P =.181). In group 2, 11 (61%) had PR/DS; 7 (39%) progressed. Mean times to disease-specific death in group 1, group 2 (+CRN), and group 2 (no-CRN) were 29.2, 4.6, and 28.7 months, respectively (P =.025). Kaplan-Meier analysis of DSS and OS demonstrated significant improvement in group 2 (+CRN) vs group 1 vs group 2 (no-CRN; P

AB - Objective: To compare outcomes of metastatic renal cell carcinoma (mRCC) patients who underwent primary cytoreductive nephrectomy (CRN), followed by adjuvant sunitinib therapy, vs those who underwent primary sunitinib therapy before planned CRN. Methods: This was a multi-institutional retrospective analysis of 35 mRCC patients from June 2005 to August 2009 (median follow-up, 28.5 months): 17 underwent primary CRN, followed by adjuvant sunitinib (group 1); 18 underwent primary sunitinib therapy, followed by planned CRN (group 2). Response to therapy was determined using Response Evaluation Criteria in Solid Tumors. Group 2 patients who had partial response (PR)/stable disease (SD) proceeded to CRN (group 2 +CRN). Group 2 patients who progressed were treated with salvage systemic therapy (group 2 no-CRN). Primary and secondary outcomes were disease-specific survival (DSS) and overall survival (OS). Results: Patient demographic and tumor characteristics were similar. The groups had similar rates of DSS and OS on univariate analysis (P =.318 and P =.181). In group 2, 11 (61%) had PR/DS; 7 (39%) progressed. Mean times to disease-specific death in group 1, group 2 (+CRN), and group 2 (no-CRN) were 29.2, 4.6, and 28.7 months, respectively (P =.025). Kaplan-Meier analysis of DSS and OS demonstrated significant improvement in group 2 (+CRN) vs group 1 vs group 2 (no-CRN; P

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