AUA 2016: Optimizing Patient Selection for Cytoreductive Nephrectomy in the Targeted Therapy Era - Session Highlights

San Diego, CA USA ( Only few treatment modalities are present for patients with metastatic renal cell carcinoma (RCC). However, in the age of targeted therapy, patient selection is becoming increasingly critical for cancer specific survival. Improved survival rates are known to arise from the combination of cytoreductive nephrectomy (CN) and cytokine therapy.

And from a retrospective review of 313 patients treated with CN between 1990 to 2010, Dr. Gershman and colleagues seek to further define an even more targeted approach by developing a risk-stratification model for the optimization of patient outcomes.

From 1990-2004, otherwise considered the immunotherapy era, 69% of the cohort received treatment. From 2005-2010, only 31% were treated during this targeted therapy era. Of the 313 total patients, 146 received post-surgical systemic therapy. With a median follow up of 9.6 years, 291 patients died, while 279 died from cancer. It was found that the most relevant criteria for predicting cancer specific survival, consisted of age being greater than or equal to 68 years, sex, constitutional symptoms, radiographic lymphadenopathy and whether patient received IVC tumor thrombosis.

The authors concluded from their findings that the risk stratified, scoring system allowed for greater discrimination in patient selection, to predict cancer specific survival in cytoreductive nephrectomy. Conversely, if patients receive a poor predicted survival, they would benefit more from systemic therapy.


Presented By: Boris Gershman, MD

Written By: Victor Huynh, CCRP, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA