Patients with renal cell carcinoma who have surgery to remove metastatic tumors are likely to double their life expectancy, according to research published in The Journal of Urology (April 2017;197:e954).
Previous studies have shown evidence that surgically removing metastases results in longer life expectancy. However, these studies did not address selection bias, relegating the data inconclusive until further study.
Mayo Clinic urologists led by Bradley Leibovich, MD, analyzed 8 previous studies to validate this claim. With the help of the Center for the Science of Health Care Delivery, researchers chose observational studies with lower risk of selection bias. The chosen studies involved 2267 patients with metastatic renal cell carcinoma.
Results of the meta-analysis showed that the total life expectancy for patients whose metastases were not surgically removed was between 8 and 24 months, whereas the total life expectancy for patients whose metastases were surgically removed was between 3 and 12 years.
"At the end of the day, we're trying to target patients who have an unfortunate diagnosis and trying to really optimize the outcome," says Harras Zaid, MD, Mayo urologic oncology fellow, the paper's lead author, in a press release (April 24, 2017).
Since the publication of the majority of the data analyzed in this study, immunotherapies and other drugs for kidney cancer have been US Food and Drug Administration approved. More than 10 approved drugs for kidney cancer treatment exist today, most of which were approved within the past decade.
"In people who haven't had complete removal of the metastases, drug therapy seems to benefit. But in patients who have that surgery, drug therapy doesn't seem to make a difference," said Dr Leibovich.
Further research is being conducted to evaluate the interaction of surgery and drugs to determine if this combination continues to improve survival. – Zachary Bessette