NEPHRECTOMY FOR LOCALLY ADVANCED RENAL CANCER

Nephrectomy for Locally Advanced Renal Cancer Improves Survival

NEW YORK (Reuters Health) Dec 25 - Nephrectomy improves cancer-specific survival in patients with locally advanced renal cell carcinoma (RCC).

"Refer patients with locally advanced RCC to tertiary care centers where, if eligible, they can benefit from surgery," Dr. Pierre I. Karakiewicz, from the University of Montreal, told Reuters Health.

Dr. Karakiewicz and colleagues examined cancer-specific survival of 43,143 patients treated with nephrectomy for locally advanced, non-metastatic RCC and compared it with that of patients managed without surgery.

Cancer-specific mortality was 5.8-fold higher for nonsurgical therapy than for nephrectomy, the authors report in the December issue of BJU International.

In a second analysis, where a subset of patients treated without surgery were matched with up to four surgically treated patients, there was still a 5.1-fold higher rate of cancer-specific mortality in the nonsurgical group than in the nephrectomy group.

Overall, 5- and 10-year estimates of cancer-specific survival were 68.6% and 57.5%, respectively, for the nephrectomy group, compared with 14.5% and 10.6%, respectively, for the nonsurgical therapy group.

"Our findings showed that nonsurgical therapy is associated with a 44.1-57.5% worse survival than nephrectomy," the investigators conclude. "Based on these findings, nephrectomy should be considered as the treatment of choice for patients with locally advanced RCC."