Primary tumor ablation in metastatic renal cell carcinoma.

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations Pub Date : 2024-11-12 DOI:10.1016/j.urolonc.2024.10.019

Lukas Scheipner, Reha-Baris Incesu, Simone Morra, Andrea Baudo, Letizia Maria Ippolita Jannello, Carolin Siech, Mario de Angelis, Anis Assad, Zhe Tian, Fred Saad, Shahrokh F Shariat, Alberto Briganti, Felix K H Chun, Derya Tilki, Nicola Longo, Luca Carmignani, Ottavio De Cobelli, Martin Pichler, Sascha Ahyai, Pierre I Karakiewicz

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引用次数: 0

Abstract

Background: The role of primary tumor ablation (pTA) in metastatic renal cell carcinoma (mRCC) is unknown. We compared pTA-treated mRCC patients to patients who underwent no local treatment (NLT), as well as patients who underwent cytoreductive nephrectomy (CN).

Methods: Within the Surveillance, Epidemiology, and End Results database (SEER, 2004-2020), we identified mRCC patients who underwent either pTA, NLT or CN. Endpoints consisted of overall survival (OM) and other-cause mortality (OCM). Propensity score 1:1 matching (PSM), multivariable cox regression models (OM), as well as, multivariable competing risk regressions (CRR) models (OCM) were used.

Results: We identified 27,087 mRCC patients, of whom 82 (0.3%) underwent pTA, 17,266 (64%) NLT and 9,739 (36%) CN. In comparisons of pTA vs. NLT mRCC patients addressing OM, after 1:1 PSM, median survival was 19 months for pTA vs. 4 months for NLT patients (multivariable HR 0.3, 95% CI 0.22-0.47, P < 0.001). No statistically significant OCM differences were recorded in multivariable CRR (HR 1.13 95%, CI 0.52-2.44, P = 0.8). In comparisons of pTA vs. CN, after 1:1 PSM, no statistically significant differences in OM (HR 1.22, 95% CI 0.81-1.83, P = 0.32), as well as OCM (HR 1.4, 95% CI 0.56-3.48, P = 0.5) were recorded.

Conclusion: In mRCC patients, pTA is associated with significantly lower mortality compared to NLT. Interestingly, OM rates between pTA and CN mRCC patients do not exhibit statistically significant differences. This preliminary report may suggest that pTA may provide a comparable survival benefit to CN in highly selected mRCC patients.

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转移性肾细胞癌的原发肿瘤消融。

背景：原发肿瘤消融术（pTA）在转移性肾细胞癌（mRCC）中的作用尚不清楚。我们将接受过 pTA 治疗的 mRCC 患者与未接受局部治疗 (NLT) 的患者以及接受过细胞肾切除术 (CN) 的患者进行了比较：在监测、流行病学和最终结果数据库（SEER，2004-2020 年）中，我们确定了接受 pTA、NLT 或 CN 治疗的 mRCC 患者。终点包括总生存期（OM）和其他原因死亡率（OCM）。采用倾向得分 1:1 匹配（PSM）、多变量 cox 回归模型（OM）以及多变量竞争风险回归模型（CRR）（OCM）：我们确定了 27087 名 mRCC 患者，其中 82 人（0.3%）接受了 pTA，17266 人（64%）接受了 NLT，9739 人（36%）接受了 CN。在比较 pTA 与 NLT mRCC 患者处理 OM 的情况时，经过 1:1 PSM，pTA 患者的中位生存期为 19 个月，NLT 患者为 4 个月（多变量 HR 0.3，95% CI 0.22-0.47，P <0.001）。在多变量 CRR 中，OCM 差异无统计学意义（HR 1.13 95%，CI 0.52-2.44，P = 0.8）。在 pTA 与 CN 的比较中，经过 1:1 PSM 后，OM（HR 1.22，95% CI 0.81-1.83，P = 0.32）和 OCM（HR 1.4，95% CI 0.56-3.48，P = 0.5）差异无统计学意义：结论：在mRCC患者中，与NLT相比，pTA可显著降低死亡率。有趣的是，pTA 和 CN mRCC 患者的 OM 率在统计学上没有显著差异。这份初步报告可能表明，在高度筛选的 mRCC 患者中，pTA 可提供与 CN 相当的生存获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologic Oncology-seminars and Original Investigations 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.70%

发文量

297

审稿时长

7.6 weeks

期刊介绍： Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.