Is there a role for cytoreductive nephrectomy?

This discussion with Dr Paul Russo presents a case for cytoreductive nephrectomy, despite the results from the CARMENA trial, which did not show an overall survival advantage. The report concludes that careful selection of patients with intermediate-risk (not poor-risk) metastatic renal cell carcinoma (RCC) and cytoreductive nephrectomy performed by experienced surgeons, followed by treatment with […]

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The role of cytoreductive nephrectomy in metastatic kidney cancer

Around 12,500 new cases of renal cell carcinoma (RCC) are diagnosed annually in the UK, and about a third of these cases initially present with cancer that has spread to other parts of the body (non-localised or metastatic). Non-localised RCC has significantly worse 5-year survival outcomes compared with localised disease. The treatment options for patients […]

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ASCO 2019: Analysis of CARMENA trial results using IMDC risk groups

The results from CARMENA, a randomised phase III clinical trial to assess the importance of surgery to remove the kidney (nephrectomy) in people with metastatic kidney cancer, have been re-analysed and were presented at the 2019 American Society of Clinical Oncology (ACSO) annual meeting in Chicago this week. The original results showed that many people with […]

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Surgery may not be the most appropriate frontline treatment for metastatic kidney cancer

Results of the phase 3 SURTIME trial comparing pretreatment with sunitinib before nephrectomy, with immediate nephrectomy followed by sunitinib treatment were published in JAMA Oncology recently. The findings suggest that pretreating metastatic renal cell carcinoma (RCC) patients with sunitinib before surgery may lead to better or at least similar outcomes for patients compared to immediate nephrectomy. Although […]

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ESOU 2019: Adjuvant therapy after nephrectomy for high-risk renal cell carcinoma

The following presentations were given at the European Association of Urology (EAU) Section of Oncological Urology (ESOU) conference in Prague, Czech Republic last week. The first presentation approached the discussion of adjuvant therapy after nephrectomy for high-risk renal cell carcinoma (RCC) from a urologist’s perspective, while the second presentation presents the oncologist’s perspective. Read the urologist’s perspective […]

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Pros and cons of lymph node dissection at the time of nephrectomy

The following two presentations were given at the Canadian Uro-oncology Summit in Toronto last week on the pros and cons of removing lymph nodes during nephrectomy for renal cell carcinoma (RCC). In summary, lymph node dissection may be curative in patients with non-metastatic RCC, and may improve the patient’s response to systemic treatment in patients […]

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Deferred cytoreductive nephrectomy in kidney cancer fails to improve progression-free survival

Results from the phase 3 CARMENA study, published in the journal JAMA Oncology, found that pretreatment of renal cell carcinoma (RCC) patients with sunitinib followed by deferred cytoreductive nephrectomy did not improve 28-week progression-free survival rates compared with immediate nephrectomy followed by sunitinib in these patients. However, patients who received sunitinib followed by deferred cytoreductive […]

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Neoadjuvant axitinib shrinks kidney tumours to allow for partial nephrectomy

A recent phase II study of 18 patients with clear-cell renal cell carcinoma (RCC) stage cT2a showed that treatment with axitinib before surgery (neoadjuvant treatment) reduced the size of the tumour. Before treatment with axtinib, these patients were not considered suitable for partial nephrectomy. Neoadjuvant treatment with axitinib enabled 67% of patients to undergo partial nephrectomy […]

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Should the primary kidney tumour be treated in metastatic disease?

Dr Gennady Bratslavsky gave a presentation at a urology symposium in Israel last week discussing the question of whether the primary tumour should be treated in metastatic renal cell carcinoma (RCC). The outline of his presentation included: Current guidelines for metastatic RCC The rational behind cytoreductive nephrectomy (CN) Historical evidence supporting current guidelines A discussion […]

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CARMENA trial results show that many people with advanced kidney cancer do not need surgery

The results from CARMENA, a randomised phase III clinical trial to assess the importance of surgery to remove the kidney (nephrectomy) in people with metastatic kidney cancer, were presented at the 2018 American Society of Clinical Oncology (ACSO) annual meeting in Chicago this week. The results showed that many people with metastatic kidney cancer can […]

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