Mp51-18 Population-Based Trends and Outcomes for Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma in the United States

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (MP51)1 May 2024MP51-18 POPULATION-BASED TRENDS AND OUTCOMES FOR CYTOREDUCTIVE NEPHRECTOMY FOR METASTATIC RENAL CELL CARCINOMA IN THE UNITED STATES Brett Wiesen, Justin Achua, Adam Warren, Boris Gershman, Corbin Eule, and Simon Kim Brett WiesenBrett Wiesen , Justin AchuaJustin Achua , Adam WarrenAdam Warren , Boris GershmanBoris Gershman , Corbin EuleCorbin Eule , and Simon KimSimon Kim View All Author Informationhttps://doi.org/10.1097/01.JU.0001009492.49624.4b.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The clinical benefits of cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC) remains uncertain. Since the CARMENA trial showing minimal benefit, the contemporary use of CN and its survival benefits remains unknown. Herein, we aimed to identify the current trends of CN and factors associated with its use along with overall survival (OS) from a population-based cohort. METHODS: From 2013 to 2023, we identified all patients with mRCC (staged Tany Nany M1) within the Cancer Lin-Q, which is a national database of medical oncology practices in the U.S. The primary outcomes were use of CN and overall survival at 5 years. Multivariable logistic regression analyses were used to identify factors associated with CN including age, race, ECOG performance status, gender, and year. Cox proportional hazard ratios were used determine covariates associated with OS including age, race, gender, ECOG performance status, T stage, N stage, tumor histology, and year. RESULTS: Amongst the 584 patients with mRCC, 66 patients underwent CN in the U.S. During the study interval, the use of CN dramatically decreased from 2019 – 2020 (OR: 0.045; p=0.004), 2021 – 2023 (OR: 0.08; p=0.0002) compared to 2013 – 2014 on multivariable analysis (Table 1). However, patients undergoing CN was associated with better overall survival on multivariable analysis (HR: 1.45; p=0.04) and Kaplan Meier analysis (Figure 1). CONCLUSIONS: The use of CN has substantially decreased in the United States. However, we demonstrated a decrease in OS for those not undergoing CN over a 5-year interval. Further study is needed to elucidate the role of CN moving forward as the treatment landscape continues to evolve for mRCC. Download PPT Source of Funding: Schramm Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e849 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Brett Wiesen More articles by this author Justin Achua More articles by this author Adam Warren More articles by this author Boris Gershman More articles by this author Corbin Eule More articles by this author Simon Kim More articles by this author Expand All Advertisement PDF downloadLoading ...