Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/23587
Title: An evaluation of the role of tumor load in cytoreductive nephrectomy.
Austin Authors: Silagy, Andrew W;Duzgol, Cihan;Marcon, Julian;DiNatale, Renzo G;Mano, Roy;Blum, Kyle A;Reznik, Ed;Voss, Martin H;Motzer, Robert J;Coleman, Jonathan A;Russo, Paul;Akin, Oguz;Hakimi, A Ari
Affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Issue Date: 16-Jun-2020
metadata.dc.date: 2020-06-16
Publication information: Canadian Urological Association journal = Journal de l'Association des urologues du Canada 2020; online first: 16 June
Abstract: New radiological tools can accurately provide preoperative three-dimensional spatial assessment of metastatic renal cell carcinoma (RCC) We aimed to determine whether the distribution, volume, shape, and fraction of RCC resected in a cytoreductive nephrectomy associates with survival. We retrospectively reviewed 560 patients undergoing cytoreductive nephrectomy performing a comprehensive volumetric analysis in eligible patients of all detectable primary and metastatic RCC prior to surgery. We used Cox regression analysis to determine the association between the volume, shape, fraction resected, and distribution of RCC and overall survival (OS). There were 62 patients eligible for volumetric analysis, with similar baseline characteristics to the entire cohort, and median survivor followup was 34 months. Larger primary tumors were less spherical, but not associated with different metastatic patterns. Increased primary tumor volume and tumor size, but not the fraction of tumor resected, were associated with inferior survival. The rank of tumors based on unidimensional size did not completely correspond to the rank by primary tumor volume, however, both measurements yielded similar concordance for predicted OS. Larger tumor volume was not associated with a longer postoperative time off treatment. Primary tumor volume was significant for predicting OS, while the fraction of disease resected did not appear to impact upon patient outcomes. Although rich in detail, our study is potentially limited by selection bias. Future temporal studies may help elucidate whether the primary tumor shape is associated with tumor growth kinetics.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23587
DOI: 10.5489/cuaj.6350
PubMed URL: 32569570
ISSN: 1911-6470
Type: Journal Article
Appears in Collections:Journal articles

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