Abern Michael R, Scosyrev Emelian, Tsivian Matvey, Messing Edward M, Polascik Thomas J, Dudek Arkadiusz Z
820 S. Wood Street Suite 515, Chicago, IL, 60612, U.S.A.
Anticancer Res. 2014 May;34(5):2405-11.
BACKGROUND/AIM: In the cytokine era, cytoreductive nephrectomy (CN) improves survival for patients with metastatic renal cell carcinoma (mRCC). We analyzed the effect of CN on the survival of patients diagnosed with mRCC in the era of tyrosine kinase inhibitors (2005-present).
The Surveillance, Epidemiology, and End Results (SEER) database was used to identify adult patients diagnosed with mRCC between 2005 and 2009. The primary outcome was overall survival, analyzed with multivariable Cox models.
Out of 7,143 incident mRCC cases reported to SEER between 2005-2009, 2,629 (37%) underwent CN. Patients undergoing CN were younger, and more likely to be white, male, and married. Patients with stage T3 tumors were most likely to undergo CN (64%). Patients that underwent CN had improved one-year survival (61% vs. 22%). On multivariable analysis, CN was associated with improved overall survival(hazard ratio[HR]=0.40 95% confidence interval [CI]=0.37-0.43).
In the targeted-therapy era, patients with mRCC undergoing CN have improved survival after adjusting for tumor stage and demographic characteristics.
背景/目的：在细胞因子时代，减瘤性肾切除术（CN）可提高转移性肾细胞癌（mRCC）患者的生存率。我们分析了在酪氨酸激酶抑制剂时代（2005年至今）CN对诊断为mRCC患者生存率的影响。
利用监测、流行病学和最终结果（SEER）数据库确定2005年至2009年间诊断为mRCC的成年患者。主要结局为总生存期，采用多变量Cox模型进行分析。
在2005 - 2009年间向SEER报告的7143例新发mRCC病例中，2629例（37%）接受了CN。接受CN的患者更年轻，更可能是白人、男性且已婚。T3期肿瘤患者接受CN的可能性最大（64%）。接受CN的患者1年生存率有所提高（61%对22%）。多变量分析显示，CN与总生存期改善相关（风险比[HR]=0.40，95%置信区间[CI]=0.37 - 0.43）。
在靶向治疗时代，调整肿瘤分期和人口统计学特征后，接受CN的mRCC患者生存率有所提高。
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