Background. Cytoreductive partial nephrectomy (CPN) for metastatic renal cell cancer (mRCC) is currently used infrequently and prognostic factors affecting survival rates for this cytoreductive surgery are currently undefined. Aim. To determine the prognostic factors influencing the survival rates in mRCC patients when performing CPN in real clinical practice. Materials and methods. The retrospective study included 32 patients who underwent CPN at the Municipal Oncologic Hospital No. 62 in Moscow and the Municipal Oncologic Dispensary in St. Petersburg from 2014 to 2022. Clinical data from medical records were obtained and analyzed retrospectively, all patients underwent clinical, laboratory, and pathomorphological examination. Patients' survival rates were evaluated using the statistical method of Survival Analysis with calculation of descriptive characteristics of life time in the form of a life table and construction of Kaplan–Meier curves. Results. In the present study, clear-cell variant of CPN occurred in 84.4 %, low-differentiated tumors – 21.9 %; synchronous metastases – 21.9 % and multiple metastases 59.4 %. A favorable prognosis according to IMDC was noted in 34.4 % of patients. Lung metastases were detected most often (53,1 %), the predominant number of patients (96.9 %) were treated with systemic therapy with targeted drugs. The length of hospital stay was 3.8 ± 6.2 % days, 30-day mortality – 3.1 %. The 3- and 5-year overall survival rates were 74 % and 62 %, respectively. Conclusion. The tactics for cytoreductive partial nephrectomy in mRCC are currently undefined. Multivariate analysis revealed an independent negative effect of gender (p = 0.041), bone (p = 0.003) and lung (p = 0.022) metastases, and ECOG status (p = 0.03) on overall survival rates.
Semenov et al. (Mon,) studied this question.