Retrospective Analysis of Locally Advanced Non-Metastatic Renal Cell Carcinoma

the Cancer Therapy Advisor take:

Researchers recently conducted a retrospective review of 23 years of data from Memorial Sloan Kettering Cancer Center that captured the experience of patients who received a surgical resection and utilized concurrent adrenalectomy and lymphadenectomy for locally advanced non-metastatic renal cell carcinoma.

The review included 802 patients who underwent nephrectomy, with or without concurrent adrenalectomy or lymphadenectomy, for locally advanced renal cell carcinoma defined as stage ≥T3 and M0.

The study excluded patients who received adjuvant treatment within a 3 month period of their surgery, patients that had less than 3 months of follow-up, and patients that had bilateral renal masses.

The Kaplan-Meier method was used to estimate 5-year and 10-year progression free overall survival for patients being analyzed and differences between each group of patients were analyzed via the log-rank test. The researchers found that 596 (74%) and 206 (26%) patients underwent radical and partial nephrectomy, respectively.

Progression of renal cell carcinoma occurred in 189 patients and 104 patient died as a result. The median follow-up for patients whose disease did not progress was 4.6 years.

The researchers determined that factors such as symptoms at presentation, tumor stage, lymph node status, American Society of Anesthesiologists classification, histologic subtype, and tumor grade were significantly associated with progression-free and overall survival.

The multivariate analysis indicated that adrenalectomy utilization lymphadenectomy increased with odds ratio 1.16 per year and adrenalectomy utilization decreased over time with odds ratio .82 per year. The researchers also found that larger tumors were indicative of a higher instance of concurrent adrenalectomy and lymphadenectomy.