Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Incesu, RB; Barletta, F; Garcia, CC; Scheipner, L; Morra, S; Baudo, A; Assad, A; Tian, Z; Saad, F; Shariat, SF; Carmignani, L; Longo, N; Ahyai, S; Chun, FKH; Briganti, A; Tilki, D; Graefen, M; Karakiewicz, PI.
The Effect of Treatment Intensification on Other-Cause Mortality in Clear-Cell Metastatic Renal Cell Carcinoma Patients.
Clin Genitourin Cancer. 2024; 22(2):420-425
Doi: 10.1016/j.clgc.2023.12.013
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Ahyai Sascha
- Scheipner Lukas
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- Abstract:
- BACKGROUND: The effect of treatment intensification (systemic therapy [ST] + cytoreductive nephrectomy (CN) vs. ST alone) is unknown regarding rates of other-cause mortality (OCM) in clear-cell metastatic renal cell carcinoma (ccmRCC). We hypothesized that intensified treatment (ST + CN) may result in higher OCM, than when ST is used alone. METHODS: Within the Surveillance, Epidemiology, and End Results database, all ccmRCC patients treated 2010-2018 either with ST + CN or ST alone were identified. Propensity score matching (PSM), cumulative incidence plots, multivariable competing risks regression analyses and 6 months' landmark analyses addressed OCM and cancer-specific mortality (CSM) according to treatment status. RESULTS: Of 2271 ccmRCC patients, 1233 (54%) were treated with ST + CN vs 1038 (46%) with ST alone. After 1:1 PSM, OCM was 5.3 vs. 4.6 % (P = .5) and CSM was 73.4 vs. 88.4% (P < .001) in ST + CN vs. ST alone patients. In multivariable competing risks regression, the combination of ST and CN was not associated with higher OCM (HR 1.3; 95% CI 0.8-2.1; P = .4), vs. ST alone. However, the combination of ST and CN was independently associated with lower CSM (HR 0.5; 95% CI 0.5-0.6; P < .001), vs. ST alone. After 6 months' landmark analyses, these multivariable associations remained unchanged. CONCLUSIONS: The current study indicates no OCM-disadvantage in ST + CN ccmRCC patients, relative to their ST alone counterparts. Conversely, a strong association with lower CSM was recorded in ST + CN patients, relative to their ST alone counterparts. These associations are robust and remained unchanged after strictest statistical adjustment including control for immortal time bias.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Carcinoma, Renal Cell - pathology
- Kidney Neoplasms - pathology
- SEER Program - administration & dosage
- Nephrectomy - methods
- Find related publications in this database (Keywords)
- cytoreductive nephrectomy
- systemic therapy
- other -cause mortality
- clear -cell metastatic renal cell
- carcinoma
- treatment intensification