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• W2912637557 abstract "You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy VI1 Apr 2016PD48-06 THE ROLE OF METASTASECTOMY IN PATIENTS WITH RENAL CELL CARCINOMA WITH SARCOMATOID DEDIFFERENTIATION: A MATCHED CONTROLLED ANALYSIS Arun Thomas, Mehrad Adibi, Rebecca Slack, Borregales Leonardo, Megan Merrill, Pheroze Tamboli, Kanishka Sircar, Eric Jonasch, Surena Matin, Christopher Wood, and Jose Karam Arun ThomasArun Thomas More articles by this author , Mehrad AdibiMehrad Adibi More articles by this author , Rebecca SlackRebecca Slack More articles by this author , Borregales LeonardoBorregales Leonardo More articles by this author , Megan MerrillMegan Merrill More articles by this author , Pheroze TamboliPheroze Tamboli More articles by this author , Kanishka SircarKanishka Sircar More articles by this author , Eric JonaschEric Jonasch More articles by this author , Surena MatinSurena Matin More articles by this author , Christopher WoodChristopher Wood More articles by this author , and Jose KaramJose Karam More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2728AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal cell carcinoma with sarcomatoid dedifferentiation (sRCC) is an aggressive tumor generally associated with a poor clinical course. Management of metastatic sRCC remains a therapeutic challenge with no standard treatment strategies. Our objective was to evaluate whether metastasectomy has any survival benefit in patients with synchronous or asynchronous metastatic sRCC treated with radical nephrectomy (RN) METHODS From an institutional database of 273 patients with sRCC treated with nephrectomy, we matched 80 patients with synchronous and asynchronous metastasis for age, ECOG performance status, histology and nodal status. Matched pairs were then retained only if patients who did not undergo metastasectomy were comparably alive at the time of metastasectomy in matched surgical patients to reduce the bias in survival outcomes. Overall survival (OS) from nephrectomy was studied using univariable and multivariable proportional hazards regression. RESULTS Median OS was 8.3 months (95%CI 6.5-10.5 months) and 18.5 months (95%CI 11.5-42.9 months) for patients with synchronous and asynchronous metastases, respectively. OS for patients undergoing metastasectomy for synchronous metastasis was comparable to non-surgical patients (8.4 and 8.0 months, respectively, p=0.35). Similarly, within the asynchronous cohort, median OS was 36.2 months (95%CI 7.6-Not Reached) in the metastasectomy group and 13.7 months (95%CI 8.8-41.6) in the non-metastasectomy group (p=0.29). On multivariable analysis, positive lymph node (LN) at nephrectomy was associated with increased risk of death in both synchronous and asynchronous patients groups; (HR=2.1 [95%CI 1.1-4.0] p=0.03) and (HR=3.3 [95%CI 1.2-9.2] p=0.02), respectively CONCLUSIONS Metastasectomy in patients with synchronous or asynchronous metastases after nephrectomy does not appear to confer significant survival benefit in patients with sRCC, particularly in patients with pathological LN positive disease at nephrectomy © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1177 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Arun Thomas More articles by this author Mehrad Adibi More articles by this author Rebecca Slack More articles by this author Borregales Leonardo More articles by this author Megan Merrill More articles by this author Pheroze Tamboli More articles by this author Kanishka Sircar More articles by this author Eric Jonasch More articles by this author Surena Matin More articles by this author Christopher Wood More articles by this author Jose Karam More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2912637557 title "PD48-06 THE ROLE OF METASTASECTOMY IN PATIENTS WITH RENAL CELL CARCINOMA WITH SARCOMATOID DEDIFFERENTIATION: A MATCHED CONTROLLED ANALYSIS" @default.
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