Laparoscopic cytoreductive nephrectomy is associated with significantly improved survival compared with open cytoreductive nephrectomy or targeted therapy alone

  • Authors:
    • Kaidong Zhao
    • Eric H. Kim
    • Joel M. Vetter
    • James J. Hsieh
    • Ramakrishna Venkatesh
    • Sam B. Bhayani
    • R. Sherburne Figenshau
  • View Affiliations

  • Published online on: September 21, 2020     https://doi.org/10.3892/mco.2020.2141
  • Article Number: 71
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Abstract

The aim of the present study was to compare the survival outcomes for patients with metastatic renal cell carcinoma (mRCC) who underwent laparoscopic cytoreductive nephrectomy (CN) vs. open CN vs. targeted therapy (TT) alone at our institution. A retrospective chart review was performed at our institution for patients who underwent CN prior to TT (laparoscopic, n=48; open, n=48) or who were deemed unfit for surgery and received TT alone (n=36), between January 2007 and December 2012. Kaplan‑Meier estimated survival and Cox proportional hazards analyses were performed. Laparoscopic CN was associated with significantly longer survival compared with open CN or TT alone (median survival 24 vs. <12 months, respectively; P<0.01). On multivariate analysis, laparoscopic CN was an independent predictor of survival [hazard ratio (HR)=0.48, P<0.01), controlling for preoperative risk factors, while survival was similar between open CN and TT alone (HR=0.85, P=0.54). In our experience, laparoscopic CN appears to be a significant predictor of survival in mRCC. Selection bias of the surgeon for patients with improved survival may account for clinical variables that were otherwise difficult to quantify. For patients who were not candidates for laparoscopic CN, open CN did not confer a survival benefit over TT alone, while it was associated with increased morbidity.
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December-2020
Volume 13 Issue 6

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Spandidos Publications style
Zhao K, Kim EH, Vetter JM, Hsieh JJ, Venkatesh R, Bhayani SB and Figenshau RS: Laparoscopic cytoreductive nephrectomy is associated with significantly improved survival compared with open cytoreductive nephrectomy or targeted therapy alone. Mol Clin Oncol 13: 71, 2020
APA
Zhao, K., Kim, E.H., Vetter, J.M., Hsieh, J.J., Venkatesh, R., Bhayani, S.B., & Figenshau, R.S. (2020). Laparoscopic cytoreductive nephrectomy is associated with significantly improved survival compared with open cytoreductive nephrectomy or targeted therapy alone. Molecular and Clinical Oncology, 13, 71. https://doi.org/10.3892/mco.2020.2141
MLA
Zhao, K., Kim, E. H., Vetter, J. M., Hsieh, J. J., Venkatesh, R., Bhayani, S. B., Figenshau, R. S."Laparoscopic cytoreductive nephrectomy is associated with significantly improved survival compared with open cytoreductive nephrectomy or targeted therapy alone". Molecular and Clinical Oncology 13.6 (2020): 71.
Chicago
Zhao, K., Kim, E. H., Vetter, J. M., Hsieh, J. J., Venkatesh, R., Bhayani, S. B., Figenshau, R. S."Laparoscopic cytoreductive nephrectomy is associated with significantly improved survival compared with open cytoreductive nephrectomy or targeted therapy alone". Molecular and Clinical Oncology 13, no. 6 (2020): 71. https://doi.org/10.3892/mco.2020.2141