Adjuvant interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy after radical nephrectomy for locally advanced renal cell carcinoma

Abstract

Objectives To investigate the efficacy of interleukin-2 (IL-2), interferon-alpha, and 5-fluorouracil combination immunochemotherapy as adjuvant therapy after radical nephrectomy for nonmetastatic pathologic Stage T3 renal cell carcinoma. Methods Thirty patients who underwent radical nephrectomy for pT3N0M0 renal cell carcinoma at our department from June 1999 to December 2003 were studied retrospectively. Of the 30 patients, 9 (adjuvant group) also received adjuvant interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy after surgery; the other 21 (nonadjuvant group) did not. A comparative analysis of the two groups was performed with respect to disease-free and overall survival. Side effects from immunochemotherapy were also assessed. Results The adjuvant therapy and nonadjuvant therapy groups were not significantly different with respect to age, sex, Eastern Cooperative Oncology Group performance status, pathologic subtype, pathologic stage, tumor size, and Fuhrman’s grade. The two groups demonstrated a significant difference in the time to progression (log-rank test, P = 0.011). Although 3 patients had died at a mean follow-up of 23.8 months (range 7.5 to 35) in the nonadjuvant group, apparent differences between the two groups in overall survival were not statistically significant (log-rank test, P = 0.2487). Combination immunochemotherapy was mostly well tolerated, and all side effects were limited to World Health Organization grades 1 and 2. Conclusions Despite the ongoing controversy surrounding its effectiveness in the treatment of metastatic renal cell carcinoma, the results of our preliminary study suggest that interleukin-2, interferon-alpha, 5-fluorouracil combination immunochemotherapy may be effective as adjuvant therapy after complete resection of pT3N0M0 renal cell carcinoma.