論文

査読有り
2015年8月

Role of cytoreductive nephrectomy for Japanese patients with primary renal cell carcinoma in the cytokine and targeted therapy era

INTERNATIONAL JOURNAL OF UROLOGY
  • Katsunori Tatsugami
  • ,
  • Nobuo Shinohara
  • ,
  • Tsunenori Kondo
  • ,
  • Toshinari Yamasaki
  • ,
  • Masatoshi Eto
  • ,
  • Tomoyasu Tsushima
  • ,
  • Toshiro Terachi
  • ,
  • Seiji Naito

22
8
開始ページ
736
終了ページ
740
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/iju.12803
出版者・発行元
WILEY

ObjectiveTo assess the efficacy of cytoreductive nephrectomy for Japanese patients with primary metastatic renal cell carcinoma in the cytokine and targeted therapy era.
MethodsThe present retrospective study evaluated 330 Japanese patients with renal cell carcinoma who had synchronous metastases at diagnosis between 2001 and 2010. The characteristics of patients who did and did not undergo cytoreductive nephrectomy were compared.
ResultsOf the 330 patients, 254 (77.0%) underwent cytoreductive nephrectomy. Patients who underwent cytoreductive nephrectomy were younger; had better Karnofsky Performance Status; higher rates of lung metastases only and systemic therapy; lower rates of increased lactate dehydrogenase concentration and liver and multiple metastases; and a lower Memorial Sloan Kettering Cancer Center risk score. Independent predictors of poorer overall survival included clinical stage T3/4; poorer Memorial Sloan Kettering Cancer Center risk and Karnofsky Performance Status; increased C-reactive protein concentration; and absence of cytoreductive nephrectomy and systemic therapy. Median overall survival was significantly longer in the patients who did rather than did not undergo cytoreductive nephrectomy, irrespective of systemic treatment. In patients without cytoreductive nephrectomy, median overall survival was significantly longer in those who received targeted (15.5months; hazard ratio 0.45; 95% confidence interval 0.21-0.94), but not by cytokine (8.2months; hazard ratio 0.72; 95% confidence interval 0.36-1.46) compared with no systemic treatment (4.4months).
ConclusionsOverall survival seems to be significantly longer in patients undergoing cytoreductive nephrectomy. However, prospective trials are required to confirm our results, as targeted therapy might improve the survival even in the absence of cytoreductive nephrectomy.

Web of Science ® 被引用回数 : 11

リンク情報
DOI
https://doi.org/10.1111/iju.12803
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/25988793
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000358674800005&DestApp=WOS_CPL

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