The evolving role of cytoreductive nephrectomy in metastatic renal cell carcinoma.
Curr Opin Urol
; 29(5): 507-512, 2019 09.
Article
en En
| MEDLINE
| ID: mdl-31305275
ABSTRACT
PURPOSE OF REVIEW To review the evidence related to cytoreductive nephrectomy in metastatic renal cell carcinoma (mRCC) treated in the targeted therapy era, with a focus on observational studies and randomized trials. RECENT FINDINGS:
A number of retrospective observational studies exploring the role of cytoreductive nephrectomy have been reported. These have suggested an association between cytoreductive nephrectomy and survival, with hazard ratio estimates ranging from 0.39 to 0.68 in favour of cytoreductive nephrectomy. In contrast, the CARMENA randomized trial demonstrated that sunitinib alone was noninferior to cytoreductive nephrectomy followed by sunitinib in intermediate-risk and poor-risk patients. The results of the SURTIME trial suggest that initial sunitinib followed by a deferred cytoreductive nephrectomy may also be a reasonable approach in select patients.SUMMARY:
On the basis of the evidence to date, there is still a role for cytoreductive nephrectomy in the multimodality treatment of mRCC. Careful patient selection is of paramount importance and discussion in multidisciplinary tumour boards is encouraged. As the treatment landscape of mRCC continues to change, the role of cytoreductive nephrectomy in the modern immuno-oncology era will need to be explored.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Carcinoma de Células Renales
/
Procedimientos Quirúrgicos de Citorreducción
/
Sunitinib
/
Neoplasias Renales
/
Nefrectomía
/
Antineoplásicos
Tipo de estudio:
Clinical_trials
/
Observational_studies
Límite:
Humans
Idioma:
En
Revista:
Curr Opin Urol
Asunto de la revista:
UROLOGIA
Año:
2019
Tipo del documento:
Article