Abstract
5042 Background: S8949 demonstrated improved overall survival (OS) for palliative debulking nephrectomy in interferon-treated RCC patients (Flanigan, NEJM 2004). We explored clinical predictors of OS in an updated analysis with a median follow-up time of 9 years. Methods: Univariate and multivariate Cox regression analyses were performed to evaluate the impact of clinical variables potentially influencing OS (including performance status [PS] & early progressive disease [PD], among others). Results: 246 patients with advanced or metastatic RCC were randomized to interferon with or without nephrectomy. Of the 241 evaluable patients, median age was 59 years, 167 (69%) were male and 125 (52%) had PS 1. Patients randomized to nephrectomy had improved OS (Hazard Ratio [HR] 0.74, 95% CI 0.57–0.96 p=0.022), confirming the original report. Univariate analysis showed PS=1 (p<0.0001), hemoglobin below the median (p=0.015), and early PD within 90 days (p<0.0001) as poor prognostic factors. Multivariate analysis show...
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