Abstract
Purpose
This study analyzed oncological outcomes of patients with metastatic clear-cell renal cell carcinoma (ccRCC) treated with cytoreductive partial nephrectomy or nephrectomy.
Methods
This prospective non-randomized cohort study included 109 patients with metastatic ccRCC who underwent surgical treatment between 2011 and 2020. Patients were stratified into cytoreductive partial nephrectomy or nephrectomy groups. Survival curves were estimated, and Cox-regression analysis was performed to identify factors affecting potential lethality.
Results
The groups differed significantly in terms of T stage and International metastatic RCC database consortium (IMDC) risk groups, but not international society of urological pathology (ISUP) grading. The average blood loss volume was higher in the partial nephrectomy group. In contrast, the duration of post-operative stay, complication rate; and 30-day hospital readmission rate were similar between two groups. There was a significant difference in overall survival in favor of the partial nephrectomy group, who had better 7-year survival rates. Standardization based on the clinical complexity of the patients showed that cytoreductive partial nephrectomy was associated with a lower risk of death compared to nephrectomy.
Conclusion
Partial nephrectomy is a safe method of choice in patients with metastatic ccRCC. Kidney preservation in a metastatic setting can play a role in reducing potential adverse systemic therapy events and in decreasing the risk for concomitant pathology deterioration.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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This research was funded by the National Health Care System of Ukraine as a research project of National Cancer Institute of Ukraine.
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All authors whose names appear on the submission made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; YV Vitruk, MV Pikul, EO Stakhovskiy, BO Hrechko, DO Koshel drafted the work or revised it critically for important intellectual content; YV Vitruk, MV Pikul, EO Stakhovskiy, SL Semko approved the version to be published; and SL Semko, BO Hrechko, and DO Koshel. OA Voylenko and OA Kononenko agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the National Cancer Institute of Ukraine (Reference number 3277\2011).
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Vitruk, I., Voylenko, O., Stakhovsky, O. et al. Advantages of organ-sparing treatment approaches in metastatic kidney cancer. J Cancer Res Clin Oncol 149, 3131–3137 (2023). https://doi.org/10.1007/s00432-022-04216-6
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DOI: https://doi.org/10.1007/s00432-022-04216-6