The cytoreductive nephrectomy in patients with renal cell carcinoma and liver metastasis

Dr. Boda Guo, Department of Urology, Beijing Hospital, Beijing, China. The author of the study.

Background

Renal cell carcinoma (RCC) represents the 15th most common cancer worldwide. About 20% of patients with renal cell carcinoma eventually develop liver metastasis (LM). Furthermore, the liver is the only site of distant spread in very few cases. In fact, the development of liver metastasis is generally considered a poor prognostic factor. There is no consensus on the optimal clinical strategy to treat liver metastasis caused by renal cell carcinoma (RCCLM).

Why was this study done?

Most data on the nephrectomy in patients with RCCLM derived from limited case reports and small-scale case-control studies. In addition, the National Comprehensive Cancer Network clinical practice guidelines of kidney cancer (version 2.2020) showed that patients with RCCLM might not be suitable candidates for nephrectomy. Hence, the role of nephrectomy has been debated without resolution, which was the motivation for this research.

What did the researchers do and find?

The group of researchers from Beijing Hospital performed a retrospective cohort study in the SEER database. A total of 683 patients with RCCLM were extracted from the database. Prognostic factors for overall survival of RCCLM were identified. Whether before or after propensity score-matching analyses, the overall survival of patients who underwent nephrectomy was significantly longer than those without surgery (median overall survival before propensity score-matching analyses: 9 months vs 4 months, P < 0.0001; median overall survival after propensity score-matching analyses: 9 months vs 4 months, P < 0.0001 respectively).

What is the contribution of this study to our knowledge?

This study, published in the journal BJBMS, is the largest study to date exploring the role of nephrectomy in patients with RCCLM.

In conclusion, nephrectomy represents a valid option for well-selected patients with RCCLM.

Reference

Guo B, Liu S, Wang M, Hou H, Liu M. The role of cytoreductive nephrectomy in renal cell carcinoma patients with liver metastasis. Bosn J of Basic Med Sci. 2020

Editor: Edna Skopljak, MD

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