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    Kidney Ca: Cytoreductive nephrectomy appears to be protective

     
    • In a group of 606 propensity-matched metastatic renal cancer patients from the Surveillance, Epidemiology, and End Results database, upfront cytoreductive nephrectomy had a 20-month median survival compared to only 8 months without surgery (hazard ratio=0.57).
    • Researchers evaluating treatment of small renal masses found a local recurrence rate of less than 1% for surgery and nearly 11% for percutaneous ablation.
    • In mice, simultaneous laser thermal ablation and injection of sorafenib (Nexavar)-coated nanorods led to synergistic killing, with 100% absence of viable cells on subsequent inspection compared to 62% with laser thermal ablation alone.
    • Follow-up of a large multinational trial of systemic everolimus (Afinitor) versus placebo for renal angiomyolipoma confirmed early findings of safety and efficacy. One hundred and twelve patients followed for more than 4 years had sustained reduction in tumor volume and no episodes of bleeding.
    • Researchers presented a preoperative assessment model for metastatic renal cancer based on 313 cytoreductive nephrectomies performed between 1990 and 2010. Using a simple score model, they demonstrated that with a score of 0 points, cancer-specific survival at 1 year was 81% relative to only 30% for 10 points or more.
    • Reduction of renal function due to surgery does not confer the same overall survival disadvantage as pre-existing medical renal dysfunction.

    Next: Effect of perioperative transfusions on 5-year recurrence free, overall survival survival

    Benjamin P. Saylor
    Saylor is content managing editor for Urology Times.

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