MP28-05 THE IMPACT OF METASTASECTOMY ON SURVIVAL OUTCOMES OF RENAL CELL CARCINOMA: A 10-YEAR SINGLE CENTER EXPERIENCE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP28-05 THE IMPACT OF METASTASECTOMY ON SURVIVAL OUTCOMES OF RENAL CELL CARCINOMA: A 10-YEAR SINGLE CENTER EXPERIENCE Mariaconsiglia Ferriero, Manuela Costantini, Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Aldo Brassetti, Alfredo Maria Bove, Leonardo Misuraca, Andrea Iannuzzi, Salvatore Guaglianone, Michele Gallucci, and Giuseppe Simone Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Manuela CostantiniManuela Costantini More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Andrea IannuzziAndrea Iannuzzi More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Michele GallucciMichele Gallucci More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003256.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Solitary or oligometastasis from renal cell carcinoma (RCC) are considered the ideal candidate for target treatments to delay the time to systemic therapies. The role of surgical metastasectomy and its impact on survival outcomes remains poorly addressed. We evaluated the impact of mestastasectomy on overall survival in patients with oligometastatic (m) RCC. METHODS: Institutional renal cancer prospective database was queried for cases treated with partial or radical nephrectomy who developed metastatic disease during follow up. Patients with evidence of clinical metastasis at first diagnosis were excluded. Patients were unfit for metastasectomy based on surgeon's discretion (not achievable a non evident disease [NED] status after surgery), all other patients received systemic treatment. Survival probabilities were computed at 12, 24, 60 and 120 months after primary treatments. The impact of metastasectomy vs systemic treatment only cohort (reference category) was assessed with the Kaplan Meier method. Age, gender, bilaterality, histology, AJCC stage of primary tumor, surgical margins and metastasectomy were included in univariable and multivariable regression analyses to assess predictors of overall survival (OS). RESULTS: Overall, at a median follow up of 16 months after primary treatment, 168 patients with RCC developed asynchronous metastasis at adrenal gland, lung, liver, spleen, peritoneal, renal fossa, bone, nodes, brain and thyroid gland. Nine patients unfit for any treatment were excluded. The site of metastasis was treated with surgical metastasectomy (77/159, 48.4%), with or without previous or subsequent systemic treatment (Table 1), while 82/159 cases (51.2%) received only systemic treatment. Two-yr, 5-yr and 10-yr overall survival probabilities were 82.9%,72%, 62.7% respectively. At multivariable analysis, primary tumor AJCC stage and metastasectomy were independent predictors of OS probabilities (p=0.009 and <0.001, respectively). At Kaplan Meier analysis, metastasectomy improved significantly OS probabilities versus patients receiving systemic therapy (p<0.001). (Figure 1) CONCLUSIONS: When a NED status is achievable, surgical metastasectomy of mRCC significantly impact on OS delaying and not precluding further subsequent systemic treatments. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e370 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mariaconsiglia Ferriero More articles by this author Manuela Costantini More articles by this author Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Aldo Brassetti More articles by this author Alfredo Maria Bove More articles by this author Leonardo Misuraca More articles by this author Andrea Iannuzzi More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...