Cytoreductive Partial Nephrectomy Does Not Undermine Cancer Control in Metastatic Renal Cell Carcinoma: A Population-Based Study

OBJECTIVES We examined the poputation-based rates of cancer-specific survival in patients with metastatic renal cell carcinoma (MRCC) treated with either partial (PN) or radical cytoreductive nephrectomy (RN). METHODS Patients diagnosed with MRCC and treated with either PN or RN were identified within nine SEER cancer registries. Matched and unmatched Kaplan-Meier survival analyses, as well as multivariable Cox regression models compared the effect of RN (n = 1997, 97.8%) vs. PN (n = 46, 2.2%) on cancer-specific survival (CSS). Covariates consisted of age, gender, community type (rural vs urban), race, Surveillance, Epidemiology, and End Results (SEER) registry, tumor size and year of diagnosis. RESULTS In multivariable unmatched Cox regression analyses, no statistically significantly difference was found in CSS between the two groups (hazard ratio [HR] 1.40, P = .16). Similarly, no difference in CSS was found in the matched analyses (HR 1.35, log rank P = .34). CONCLUSION Cytoreductive PN does not appear to undermine survival in patients with MRCC. UROLOGY 72: 1090-1095, 2008. (C) 2008 Elsevier Inc.