MP14-17 VALIDATION OF REMARCC MODEL FOR SELECTION OF CYTOREDUCTIVE NEPHRECTOMY IN PATIENTS WITH mRCC

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (MP14)1 Sep 2021MP14-17 VALIDATION OF REMARCC MODEL FOR SELECTION OF CYTOREDUCTIVE NEPHRECTOMY IN PATIENTS WITH mRCC Shingo Hatakeyama, Sei Naito, Kazuyuki Numakura, Renpei Kato, Tomoyuki Koguchi, Takahiro Kojima, Yoshihide kawasaki, Sadafumi Kawamura, Nishiyama Hiroyuki, Akihito Ito, Yoshiyuki Kojima, Tomonori Habuch, Wataru Obara, Norihiko Tsuchiya, and Chikara Ohyama Shingo HatakeyamaShingo Hatakeyama More articles by this author , Sei NaitoSei Naito More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Renpei KatoRenpei Kato More articles by this author , Tomoyuki KoguchiTomoyuki Koguchi More articles by this author , Takahiro KojimaTakahiro Kojima More articles by this author , Yoshihide kawasakiYoshihide kawasaki More articles by this author , Sadafumi KawamuraSadafumi Kawamura More articles by this author , Nishiyama HiroyukiNishiyama Hiroyuki More articles by this author , Akihito ItoAkihito Ito More articles by this author , Yoshiyuki KojimaYoshiyuki Kojima More articles by this author , Tomonori HabuchTomonori Habuch More articles by this author , Wataru ObaraWataru Obara More articles by this author , Norihiko TsuchiyaNorihiko Tsuchiya More articles by this author , and Chikara OhyamaChikara Ohyama More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001995.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Selection of patients for cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) is challenging. We evaluated the utility of the scoring system of Registry for Metastatic RCC (REMARCC) model on overall survival in mRCC patients undergoing CN. METHODS: We identified a total of 278 patients with synchronous mRCC treated with first-line tyrosine kinase inhibitors (TKIs) between January 2008 and November 2019 from a Michinoku mRCC multi-institutional registry. Patients were divided into two groups: CN (n=146) and non-CN (n=132) groups. We compared the c-index of the REMARCC score with the International mRCC Database Consortium (IMDC) score in the CN group (n=146). Decision curve analysis was used to compare the net benefit of the REMARCC score with the IMDC score. Overall survival was estimated using Kaplan-Meier analysis. The effect of REMARCC score on overall survival was compared between the CN and non-CN groups using Cox regression analysis under the propensity score-based inverse probability of treatment weighting (IPTW) method to adjust for group imbalances. RESULTS: The median follow-up period was 18 (interquartile range: 9.4–35) months. Of 146 patients with CN, the C-index of the REMARCC model was slightly higher than that of the IMDC models (60% vs. 58%). Decision curve analysis showed a slight advantage of the REMARCC model predicting overall survival over the IMDC model. The net benefit was superior to all the other strategies up to 60% of threshold probabilities. Overall survival was significantly longer in the REMARCC low-score (0-2) than that of high-score (3-6), while it was not significantly different between the IMDC intermediate- and poor-risk groups. IPTW-adjusted Cox regression analyses showed that overall survival was significantly longer in the CN group than that in the non-CN group among the patients with the REMARCC low-score, but it was not significantly different between the groups among the patients with the REMARCC high-score. CONCLUSIONS: The REMARCC score was potentially active for selecting the optimal candidate of CN in patients treated with TKIs. A patient with the REMARCC low-score is a potential candidate for CN. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e259-e260 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shingo Hatakeyama More articles by this author Sei Naito More articles by this author Kazuyuki Numakura More articles by this author Renpei Kato More articles by this author Tomoyuki Koguchi More articles by this author Takahiro Kojima More articles by this author Yoshihide kawasaki More articles by this author Sadafumi Kawamura More articles by this author Nishiyama Hiroyuki More articles by this author Akihito Ito More articles by this author Yoshiyuki Kojima More articles by this author Tomonori Habuch More articles by this author Wataru Obara More articles by this author Norihiko Tsuchiya More articles by this author Chikara Ohyama More articles by this author Expand All Advertisement Loading ...