(UroToday.com) The 2025 South Central AUA annual meeting included a session on kidney cancer, featuring a presentation from Dr. Daniel Hernandez discussing survival outcomes in patients undergoing cytoreductive nephrectomy. Renal cell carcinoma (RCC) displays a wide spectrum of oncological prognosis and clinical behavior, and is characterized by generally poor outcomes in metastatic settings. In the past decades, several treatments have been proposed for the management of metastatic RCC. Among these, cytoreductive nephrectomy remains a controversial topic in the era of targeted therapy and immune checkpoint inhibitors.
This observational, analytical, cross-sectional, retrospective cohort study was conducted from records of patients diagnosed with metastatic RCC who underwent cytoreductive nephrectomy at the Dr. Gaudencio González Garza Hospital, National Medical Center La Raza. Patient records that met the selection criteria in the period from January 1, 2016, to April 1, 2024, were included. Kaplan-Meier curves were estimated, and the log-Rank test was used to determine whether the use of targeted therapy was associated with improved survival.
Overall, 37 patients with metastatic RCC who underwent cytoreductive nephrectomy were included, of whom 20 patients received targeted therapy and 17 did not. The most common site of metastasis was the lung (59.2%). The median overall survival was 16.5 months: 21.8 months in the targeted therapy group and 5.6 months in the non-treated group:
The 12-month overall survival rate was 64.9%, while the 12-month overall progression-free survival rate was 27%. Patients receiving targeted therapy (54.1%) had significantly higher 12-month survival rates (80% versus 47.1%, p = 0.002) compared to those without therapy, and the 12-month progression free rate was similar for both groups 25% versus 29% (p = 0.76). Multivariate analysis identified that higher Karnofsky score was associated with lower risk of mortality (adjusted OR 0.940, 95% CI 0.884-0.999, p = 0.045), and targeted therapy reduced the risk of mortality by 77.4% (adjusted OR: 0.226, 95% CI 0.09-0.574, p = 0.002).
Dr. Hernandez concluded his presentation discussing survival outcomes in patients undergoing cytoreductive nephrectomy with the following take home points:
- Post-cytoreductive nephrectomy targeted therapy significantly improves overall survival in patients with metastatic RCC
- A higher Karnofsky performance status is associated with improved survival
- These findings highlight the importance of adjuvant systemic therapy
Presented by: Daniel Hernandez, Asociacion Nacional de Urologos Egresados de la Raza (ANUER), Mexico City, Mexico
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 South Central American Urological Association (AUA) Annual Meeting, Orlando, FL, Wed, Sept 10 – Sat, Sept 13, 2025.