Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma
BACKGROUND. The role of nephron‐sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease‐specific survival of patients with MRCC was compared according to the type of surgery, NSS (N = 45) versus radical nephrectomy (RN) (N = 732), in unmatched and ma...
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| Veröffentlicht in: | Cancer 2007-12, Vol.110 (11), p.2428-2433 |
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| container_title | Cancer |
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| creator | Hutterer, Georg C. Patard, Jean‐Jacques Colombel, Marc Belldegrun, Arie S. Pfister, Christian Guille, Francois Artibani, Walter Montorsi, Francesco Pantuck, Allan J. Karakiewicz, Pierre I. |
| description | BACKGROUND.
The role of nephron‐sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease‐specific survival of patients with MRCC was compared according to the type of surgery, NSS (N = 45) versus radical nephrectomy (RN) (N = 732), in unmatched and matched analyses.
METHODS.
Kaplan‐Meier, life tables, log‐rank test, and univariate as well as multivariate Cox regression analyses addressed disease‐specific survival of NSS versus RN patients. Subsequently, up to 4 RN cases were matched with each NSS case for TNM stage, Fuhrman grade, and histology. Then, disease‐specific survival differences were tested with the log‐rank statistic. Finally, the sample size necessary to achieve 80% power in survival analyses between the 2 groups (NSS vs RN) was calculated.
RESULTS.
Of 45 NSS cases, 38 were matched with 99 of 732 RN cases. First, in multivariate unmatched analyses RN predisposes to 1.7‐fold higher RCC‐specific mortality rate; second, in matched analyses RN predisposes to 1.5‐fold higher RCC‐specific mortality rate; and third, both analyses failed to demonstrate statistically significant differences. Based on these findings it could be postulated that until further data become available, NSS does not appear to undermine RCC‐specific survival in carefully selected patients with MRCC. The power analyses demonstrated that at least 146, 48, and 76 observations per arm are necessary at 1, 2, and 3 years, respectively, to confirm survival equivalence.
CONCLUSIONS.
Although the data were limited in size and completeness, they may indicate that RCC‐specific survival may not be undermined if NSS is performed in properly selected cases. Cancer 2007. © 2007 American Cancer Society.
The disease‐specific survival of patients with metastatic renal cell carcinoma was compared according to the type of surgery, nephron‐sparing surgery (N = 45) versus radical nephrectomy (N = 732), in unmatched and matched analyses. The data were limited in size and completeness and may indicate that renal cell carcinoma‐specific survival may not be undermined if nephron‐sparing surgery is performed in properly selected cases. |
| doi_str_mv | 10.1002/cncr.23054 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68539124</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68539124</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3574-60d62c1b793c96524a0f663e3d6dc7604b1e1d94c75c5e06826f8f13b797a22f3</originalsourceid><addsrcrecordid>eNp90cuKFDEUBuAgitOObnwAyUYXQo25VVJZSjFeYFAQBXdFOjk1E6lKyiTVQ-98BH1Fn8T0dMPs3CQkfOeckB-h55RcUELYGxtsumCctOIB2lCiVUOoYA_RhhDSNa3g38_Qk5x_1KNiLX-MzqjSghLON-hPvy8xgVtt8TvAAZabFMPfX7_zYpIP1ziv6RrSHrsIGYdYsFkWMAmXiNfgIM0-AHY-g8lwVwbWj94e6nZ-ZybsA15M8RBKxre-3OAZismlXlmcIFRhYaqLSdaHOJun6NFopgzPTvs5-vbu8mv_obn6_P5j__aqsbxVopHESWbpVmlutWyZMGSUkgN30lklidhSoE4Lq1rbApEdk2M3Ul4LlGFs5Ofo1bHvkuLPFXIZZp8PTzEB4poH2bVcUyYqfH2ENsWcE4zDkvxs0n6gZDgEMBwCGO4CqPjFqeu6ncHd09OPV_DyBEy2ZhqTCdbne6dlpzVR1dGju_UT7P8zcug_9V-Ow_8BSqCjCQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68539124</pqid></control><display><type>article</type><title>Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma</title><source>MEDLINE</source><source>Wiley Online Library Free Content</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Hutterer, Georg C. ; Patard, Jean‐Jacques ; Colombel, Marc ; Belldegrun, Arie S. ; Pfister, Christian ; Guille, Francois ; Artibani, Walter ; Montorsi, Francesco ; Pantuck, Allan J. ; Karakiewicz, Pierre I.</creator><creatorcontrib>Hutterer, Georg C. ; Patard, Jean‐Jacques ; Colombel, Marc ; Belldegrun, Arie S. ; Pfister, Christian ; Guille, Francois ; Artibani, Walter ; Montorsi, Francesco ; Pantuck, Allan J. ; Karakiewicz, Pierre I.</creatorcontrib><description>BACKGROUND.
The role of nephron‐sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease‐specific survival of patients with MRCC was compared according to the type of surgery, NSS (N = 45) versus radical nephrectomy (RN) (N = 732), in unmatched and matched analyses.
METHODS.
Kaplan‐Meier, life tables, log‐rank test, and univariate as well as multivariate Cox regression analyses addressed disease‐specific survival of NSS versus RN patients. Subsequently, up to 4 RN cases were matched with each NSS case for TNM stage, Fuhrman grade, and histology. Then, disease‐specific survival differences were tested with the log‐rank statistic. Finally, the sample size necessary to achieve 80% power in survival analyses between the 2 groups (NSS vs RN) was calculated.
RESULTS.
Of 45 NSS cases, 38 were matched with 99 of 732 RN cases. First, in multivariate unmatched analyses RN predisposes to 1.7‐fold higher RCC‐specific mortality rate; second, in matched analyses RN predisposes to 1.5‐fold higher RCC‐specific mortality rate; and third, both analyses failed to demonstrate statistically significant differences. Based on these findings it could be postulated that until further data become available, NSS does not appear to undermine RCC‐specific survival in carefully selected patients with MRCC. The power analyses demonstrated that at least 146, 48, and 76 observations per arm are necessary at 1, 2, and 3 years, respectively, to confirm survival equivalence.
CONCLUSIONS.
Although the data were limited in size and completeness, they may indicate that RCC‐specific survival may not be undermined if NSS is performed in properly selected cases. Cancer 2007. © 2007 American Cancer Society.
The disease‐specific survival of patients with metastatic renal cell carcinoma was compared according to the type of surgery, nephron‐sparing surgery (N = 45) versus radical nephrectomy (N = 732), in unmatched and matched analyses. The data were limited in size and completeness and may indicate that renal cell carcinoma‐specific survival may not be undermined if nephron‐sparing surgery is performed in properly selected cases.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.23054</identifier><identifier>PMID: 17941033</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Renal Cell - mortality ; Carcinoma, Renal Cell - surgery ; Disease-Free Survival ; Female ; Humans ; Kidney Neoplasms - mortality ; Kidney Neoplasms - surgery ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Neoplasm Metastasis ; nephrectomy ; Nephrectomy - methods ; Nephrology. Urinary tract diseases ; nephron‐sparing surgery ; renal cell carcinoma ; survival ; Survival Analysis ; Survival Rate ; Treatment Outcome ; Tumors ; Tumors of the urinary system</subject><ispartof>Cancer, 2007-12, Vol.110 (11), p.2428-2433</ispartof><rights>Copyright © 2007 American Cancer Society</rights><rights>2008 INIST-CNRS</rights><rights>Copyright (c) 2007 American Cancer Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-60d62c1b793c96524a0f663e3d6dc7604b1e1d94c75c5e06826f8f13b797a22f3</citedby><cites>FETCH-LOGICAL-c3574-60d62c1b793c96524a0f663e3d6dc7604b1e1d94c75c5e06826f8f13b797a22f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.23054$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.23054$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19689907$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17941033$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hutterer, Georg C.</creatorcontrib><creatorcontrib>Patard, Jean‐Jacques</creatorcontrib><creatorcontrib>Colombel, Marc</creatorcontrib><creatorcontrib>Belldegrun, Arie S.</creatorcontrib><creatorcontrib>Pfister, Christian</creatorcontrib><creatorcontrib>Guille, Francois</creatorcontrib><creatorcontrib>Artibani, Walter</creatorcontrib><creatorcontrib>Montorsi, Francesco</creatorcontrib><creatorcontrib>Pantuck, Allan J.</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><title>Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND.
The role of nephron‐sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease‐specific survival of patients with MRCC was compared according to the type of surgery, NSS (N = 45) versus radical nephrectomy (RN) (N = 732), in unmatched and matched analyses.
METHODS.
Kaplan‐Meier, life tables, log‐rank test, and univariate as well as multivariate Cox regression analyses addressed disease‐specific survival of NSS versus RN patients. Subsequently, up to 4 RN cases were matched with each NSS case for TNM stage, Fuhrman grade, and histology. Then, disease‐specific survival differences were tested with the log‐rank statistic. Finally, the sample size necessary to achieve 80% power in survival analyses between the 2 groups (NSS vs RN) was calculated.
RESULTS.
Of 45 NSS cases, 38 were matched with 99 of 732 RN cases. First, in multivariate unmatched analyses RN predisposes to 1.7‐fold higher RCC‐specific mortality rate; second, in matched analyses RN predisposes to 1.5‐fold higher RCC‐specific mortality rate; and third, both analyses failed to demonstrate statistically significant differences. Based on these findings it could be postulated that until further data become available, NSS does not appear to undermine RCC‐specific survival in carefully selected patients with MRCC. The power analyses demonstrated that at least 146, 48, and 76 observations per arm are necessary at 1, 2, and 3 years, respectively, to confirm survival equivalence.
CONCLUSIONS.
Although the data were limited in size and completeness, they may indicate that RCC‐specific survival may not be undermined if NSS is performed in properly selected cases. Cancer 2007. © 2007 American Cancer Society.
The disease‐specific survival of patients with metastatic renal cell carcinoma was compared according to the type of surgery, nephron‐sparing surgery (N = 45) versus radical nephrectomy (N = 732), in unmatched and matched analyses. The data were limited in size and completeness and may indicate that renal cell carcinoma‐specific survival may not be undermined if nephron‐sparing surgery is performed in properly selected cases.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Renal Cell - mortality</subject><subject>Carcinoma, Renal Cell - surgery</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - surgery</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Metastasis</subject><subject>nephrectomy</subject><subject>Nephrectomy - methods</subject><subject>Nephrology. Urinary tract diseases</subject><subject>nephron‐sparing surgery</subject><subject>renal cell carcinoma</subject><subject>survival</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90cuKFDEUBuAgitOObnwAyUYXQo25VVJZSjFeYFAQBXdFOjk1E6lKyiTVQ-98BH1Fn8T0dMPs3CQkfOeckB-h55RcUELYGxtsumCctOIB2lCiVUOoYA_RhhDSNa3g38_Qk5x_1KNiLX-MzqjSghLON-hPvy8xgVtt8TvAAZabFMPfX7_zYpIP1ziv6RrSHrsIGYdYsFkWMAmXiNfgIM0-AHY-g8lwVwbWj94e6nZ-ZybsA15M8RBKxre-3OAZismlXlmcIFRhYaqLSdaHOJun6NFopgzPTvs5-vbu8mv_obn6_P5j__aqsbxVopHESWbpVmlutWyZMGSUkgN30lklidhSoE4Lq1rbApEdk2M3Ul4LlGFs5Ofo1bHvkuLPFXIZZp8PTzEB4poH2bVcUyYqfH2ENsWcE4zDkvxs0n6gZDgEMBwCGO4CqPjFqeu6ncHd09OPV_DyBEy2ZhqTCdbne6dlpzVR1dGju_UT7P8zcug_9V-Ow_8BSqCjCQ</recordid><startdate>20071201</startdate><enddate>20071201</enddate><creator>Hutterer, Georg C.</creator><creator>Patard, Jean‐Jacques</creator><creator>Colombel, Marc</creator><creator>Belldegrun, Arie S.</creator><creator>Pfister, Christian</creator><creator>Guille, Francois</creator><creator>Artibani, Walter</creator><creator>Montorsi, Francesco</creator><creator>Pantuck, Allan J.</creator><creator>Karakiewicz, Pierre I.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20071201</creationdate><title>Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma</title><author>Hutterer, Georg C. ; Patard, Jean‐Jacques ; Colombel, Marc ; Belldegrun, Arie S. ; Pfister, Christian ; Guille, Francois ; Artibani, Walter ; Montorsi, Francesco ; Pantuck, Allan J. ; Karakiewicz, Pierre I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3574-60d62c1b793c96524a0f663e3d6dc7604b1e1d94c75c5e06826f8f13b797a22f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Renal Cell - mortality</topic><topic>Carcinoma, Renal Cell - surgery</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - surgery</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Metastasis</topic><topic>nephrectomy</topic><topic>Nephrectomy - methods</topic><topic>Nephrology. Urinary tract diseases</topic><topic>nephron‐sparing surgery</topic><topic>renal cell carcinoma</topic><topic>survival</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hutterer, Georg C.</creatorcontrib><creatorcontrib>Patard, Jean‐Jacques</creatorcontrib><creatorcontrib>Colombel, Marc</creatorcontrib><creatorcontrib>Belldegrun, Arie S.</creatorcontrib><creatorcontrib>Pfister, Christian</creatorcontrib><creatorcontrib>Guille, Francois</creatorcontrib><creatorcontrib>Artibani, Walter</creatorcontrib><creatorcontrib>Montorsi, Francesco</creatorcontrib><creatorcontrib>Pantuck, Allan J.</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hutterer, Georg C.</au><au>Patard, Jean‐Jacques</au><au>Colombel, Marc</au><au>Belldegrun, Arie S.</au><au>Pfister, Christian</au><au>Guille, Francois</au><au>Artibani, Walter</au><au>Montorsi, Francesco</au><au>Pantuck, Allan J.</au><au>Karakiewicz, Pierre I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2007-12-01</date><risdate>2007</risdate><volume>110</volume><issue>11</issue><spage>2428</spage><epage>2433</epage><pages>2428-2433</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND.
The role of nephron‐sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease‐specific survival of patients with MRCC was compared according to the type of surgery, NSS (N = 45) versus radical nephrectomy (RN) (N = 732), in unmatched and matched analyses.
METHODS.
Kaplan‐Meier, life tables, log‐rank test, and univariate as well as multivariate Cox regression analyses addressed disease‐specific survival of NSS versus RN patients. Subsequently, up to 4 RN cases were matched with each NSS case for TNM stage, Fuhrman grade, and histology. Then, disease‐specific survival differences were tested with the log‐rank statistic. Finally, the sample size necessary to achieve 80% power in survival analyses between the 2 groups (NSS vs RN) was calculated.
RESULTS.
Of 45 NSS cases, 38 were matched with 99 of 732 RN cases. First, in multivariate unmatched analyses RN predisposes to 1.7‐fold higher RCC‐specific mortality rate; second, in matched analyses RN predisposes to 1.5‐fold higher RCC‐specific mortality rate; and third, both analyses failed to demonstrate statistically significant differences. Based on these findings it could be postulated that until further data become available, NSS does not appear to undermine RCC‐specific survival in carefully selected patients with MRCC. The power analyses demonstrated that at least 146, 48, and 76 observations per arm are necessary at 1, 2, and 3 years, respectively, to confirm survival equivalence.
CONCLUSIONS.
Although the data were limited in size and completeness, they may indicate that RCC‐specific survival may not be undermined if NSS is performed in properly selected cases. Cancer 2007. © 2007 American Cancer Society.
The disease‐specific survival of patients with metastatic renal cell carcinoma was compared according to the type of surgery, nephron‐sparing surgery (N = 45) versus radical nephrectomy (N = 732), in unmatched and matched analyses. The data were limited in size and completeness and may indicate that renal cell carcinoma‐specific survival may not be undermined if nephron‐sparing surgery is performed in properly selected cases.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>17941033</pmid><doi>10.1002/cncr.23054</doi><tpages>6</tpages></addata></record> |
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| ispartof | Cancer, 2007-12, Vol.110 (11), p.2428-2433 |
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| source | MEDLINE; Wiley Online Library Free Content; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Carcinoma, Renal Cell - mortality Carcinoma, Renal Cell - surgery Disease-Free Survival Female Humans Kidney Neoplasms - mortality Kidney Neoplasms - surgery Kidneys Male Medical sciences Middle Aged Neoplasm Metastasis nephrectomy Nephrectomy - methods Nephrology. Urinary tract diseases nephron‐sparing surgery renal cell carcinoma survival Survival Analysis Survival Rate Treatment Outcome Tumors Tumors of the urinary system |
| title | Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma |
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