Cytoreductive Nephrectomy — Patient Selection Is Key
Mené en France sur 450 patients atteints d'un carcinome métastatique à cellules rénales (durée médiane de suivi : 50,9 mois), cet essai de phase III évalue, du point de vue de la survie globale, la non infériorité du sunitinib seul par rapport à un traitement combinant néphrectomie et sunitinib
Metastatic renal-cell carcinoma has diverse clinical presentations ranging from incidental detection to a highly symptomatic systemic illness. Patients with metastatic renal-cell carcinoma are assigned a risk category — favorable, intermediate, or poor — on the basis of two published models containing five or six pretreatment selection factors, including presence of anemia, elevated serum calcium concentration, and degree of disability from cancer-related symptoms (performance status).1 This stratification provides important prognostic insight about whether patients should be treated with cytoreductive radical nephrectomy, systemic therapies, or both.1 Nephrectomy for stage IV disease removes the primary kidney tumor and its potential for bleeding and pain during subsequent systemic therapy for metastases. In addition, nephrectomy could possibly eliminate the primary tumor as a potential source of immunosuppressive or tumor-promoting growth factors.