World journal of urology · 2026
Role of cytoreductive nephrectomy in metastatic medullary renal cell carcinoma: controlled analysis.
СтатьяНазвание и аннотация: Перевод в очереди
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Le Quynh Chi, Marmiroli Andrea, Longoni Mattia, Falkenbach Fabian, Catanzaro Calogero, Nicolazzini Michele, Polverino Federico, Goyal Jordan A, Saad Fred, Schiavina Riccardo, Carmignani Luca Fabio, Briganti Alberto, Longo Nicola, Graefen Markus, Palumbo Carlotta, Siech Carolin, Banek Severine, Traumann Miriam, Chun Felix K-H, Karakiewicz Pierre I
Аннотация
OBJECTIVE: To test for differences in overall survival (OS) according to cytoreductive nephrectomy (CN) in medullary metastatic renal cell carcinoma (med-mRCC) relative to most comparable clear cell metastatic RCC (cc-mRCC) patients.
METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database (2000-2021), we identified 62 patients with med-mRCC vs. 10,372 with cc-mRCC. Propensity score matching (PSM, ratio 1:3), Kaplan-Meier plots and multivariable Cox regression analyses addressed were used.
RESULTS: Of 10,434 patients, 62 (0.6%) harbored med-mRCC vs. 10,372 (99.4%) cc-mRCC. Med-mRCC patients were younger (27 vs. 63 years, p < 0.001), more frequently African American (74 vs. 6%, p < 0.001) and more frequently harbored N1 stages (52 vs. 28%, p < 0.001). After 1:3 PSM for age, race/ethnicity, T-stage and N-stage, 62 of 62 (100%) med-mRCC (median OS 4 months) and 186 of 10,372 (2%) cc-mRCC patients (median OS 10 months) remained for further analyses. In med-mRCC, median OS was 9 months with CN vs. 3 months without CN (p = 0.01). In cc-mRCC, median OS was 28 months with CN vs. 5 months without CN (p < 0.001). In med-mRCC, CN independently predicted better OS (Hazard's Ratio [HR] 0.5, p = 0.005), as well as in cc-mRCC (HR 0.4, p < 0.001).
CONCLUSION: Med-mRCC patients exhibit a drastically different phenotype relative to their cc-mRCC counterparts. Despite this difference, med-mRCC exposed to CN harbor a similar relative protective survival effect compared to their cc-mRCC counterparts with most comparable age, race/ethnicity and tumor characteristics.
METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database (2000-2021), we identified 62 patients with med-mRCC vs. 10,372 with cc-mRCC. Propensity score matching (PSM, ratio 1:3), Kaplan-Meier plots and multivariable Cox regression analyses addressed were used.
RESULTS: Of 10,434 patients, 62 (0.6%) harbored med-mRCC vs. 10,372 (99.4%) cc-mRCC. Med-mRCC patients were younger (27 vs. 63 years, p < 0.001), more frequently African American (74 vs. 6%, p < 0.001) and more frequently harbored N1 stages (52 vs. 28%, p < 0.001). After 1:3 PSM for age, race/ethnicity, T-stage and N-stage, 62 of 62 (100%) med-mRCC (median OS 4 months) and 186 of 10,372 (2%) cc-mRCC patients (median OS 10 months) remained for further analyses. In med-mRCC, median OS was 9 months with CN vs. 3 months without CN (p = 0.01). In cc-mRCC, median OS was 28 months with CN vs. 5 months without CN (p < 0.001). In med-mRCC, CN independently predicted better OS (Hazard's Ratio [HR] 0.5, p = 0.005), as well as in cc-mRCC (HR 0.4, p < 0.001).
CONCLUSION: Med-mRCC patients exhibit a drastically different phenotype relative to their cc-mRCC counterparts. Despite this difference, med-mRCC exposed to CN harbor a similar relative protective survival effect compared to their cc-mRCC counterparts with most comparable age, race/ethnicity and tumor characteristics.