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Surgery of locally advanced and metastatic kidney cancer after tyrosine kinase inhibitors therapy: single institute experience. | LitMetric

AI Article Synopsis

  • Renal cell carcinoma (RCC) is the most prevalent kidney tumor, with advanced stages classified under TNM as stages III and IV, and treatment options include curative, cytoreductive, and palliative surgeries alongside targeted therapies.
  • A study from February 2007 to September 2014 involved 33 patients with locally advanced or metastatic RCC who received tyrosine kinase inhibitor (TKI) therapy before undergoing surgical procedures such as nephrectomy or metastasectomy.
  • Results indicated that 60% of patients had stable disease post-TKI, and while 51% experienced some surgical complications, the overall association of TKI therapy and surgery showed no major contraindications or excessive risk of postoperative issues.

Article Abstract

Purpose:: Renal cell carcinoma (RCC) is the most common tumor of the kidney. Considering the TNM classification of 2009, locally advanced and metastatic diseases are included in the groups stage III and IV. The surgical treatment of these tumors could be divided into 3 categories: (1) curative (nephrectomy and/or metastasectomy), (2) cytoreductive, and (3) palliative. Targeted agents showed impressive antitumor efficacy and prolongation of progression-free survival. The integration between target therapy and surgery in patients with locally advanced or metastatic RCC has sometimes facilitated surgery. We aimed to evaluate patients' response to tyrosine kinase inhibitor (TKI) therapy and the feasibility of surgery after that and to observe complications related to surgery.

Methods:: From February 2007 to September 2014 in the Istituto Tumori of Milan, IRCCS, we selected patients with locally advanced or metastatic diseases, treated with target therapy before surgery (which comprised nephrectomy or partial nephrectomy, cytoreductive surgery, and metastasectomy) and cryoablation.

Results:: We selected 33 patients who underwent surgery after TKI therapy. As for response to TKIs, 20 patients (60%) had stable disease, 9 patients (28%) had a partial response, and 4 patients (12%) had progressive disease. A total of 17 patients (51%) presented complications directly or indirectly related to surgery and most of those were classified as grade II Clavien-Dindo score.

Conclusions:: The association between TKI and surgery seems to have no contraindications. Our dataset provides an example of how surgery after TKI is possible in locally advanced metastatic tumor and does not have an excessive rate of postoperative complications.

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Source
http://dx.doi.org/10.5301/tj.5000596DOI Listing

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