Cytoreductive nephrectomy in metastatic renal cell carcinoma: outcome of patients treated with a multidisciplinary, algorithm-driven approach

Liu, Wing K.; Lam, Jie M.; Butters, T.; Grant, Michael; Jackson-Spence, Francesca; Bex, Axel; Powles, Thomas; Szabados, Bernadett

doi:10.1007/s00345-020-03107-0

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…When the treatment decision was taken by the MDT, it was associated with a lower five-year cancer-specific mortality in non-ccRCC, but not ccRCC. The relationship between MDT discussion and mortality in cancer patients has been debated, with one study showing no positive benefit for metastatic RCC after an adjustment for clinical factors, and other studies showing no significant relationship for other cancer types [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study

Azawi,

Ebbestad,

Nadler

et al. 2023

Cancers

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Background: The aim was to investigate whether patient-related or clinical risk factors present at the diagnosis of advanced stage renal cell carcinoma (RCC) had an impact on the overall mortality, cancer-specific mortality, and recurrence risk in a national cohort. Methods: Patients registered with stage III and IV RCC in the Danish Renal Cancer Database (DaRenCa) in 2014–2016 were included in the study and followed up until recurrence or death. We conducted a Cox Proportional Hazard Model to examine the association between several variables and the development of RCC. These variables included BMI, hypertension, smoking status, symptoms at diagnosis, performance status, multidisciplinary team (MDT) discussion, surgical margin, and primary metastasis. Separate analyses were performed for cc-RCC and non-ccRCC patients. Results: In our cohort of 929 patients, 424 individuals died from RCC during the follow-up period, with a median follow-up time of 4.1 (95% CI: 0.8–5.0) years for ccRCC and 2.0 (95% CI: 0.1–5.0) years for non-ccRCC. A multivariate analysis demonstrated that a positive surgical margin (HR 1.53 and 1.43), synchronous metastasis (HR 2.06 and 3.23), and poor performance status (HR 4.73 and 5.27) were significantly associated with a decreased 5-year overall and cancer-specific survival, respectively. Furthermore, a positive surgical margin was associated with a higher risk of recurrence in ccRCC. MDT discussion was found to reduce mortality risk in non-ccRCC. Conclusion: Clinical- and disease-related variables have a greater impact on RCC mortality and recurrence than the selected lifestyle-related factors. The inclusion of MDT discussion in the diagnosis and management of advanced RCC should be further evaluated for its potential to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study

Azawi,

Ebbestad,

Nadler

et al. 2023

Cancers

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“…Identifying mutations/altered pathways through nextgeneration sequencing, which can be targeted with a specific drug, is one of the predominant needs in this subgroup of patients to improve risk outcome and tailor treatment options. Multidisciplinary discussion among several specialists is mandatory in these cases [43].…”

Section: Summary and Final Treatment Recommendationsmentioning

confidence: 99%

Management of Metastatic Nonclear Renal Cell Carcinoma: What Are the Options and Challenges?

Mir

Albigès

Bex

et al. 2021

European Urology Oncology

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A 68-yr-old female patient presented to the accident and emergency department following a car accident with head injury. Computed tomography (CT) of the head revealed a mass in the lateral region of the skull. No further findings were evidenced within the brain structures. The patient had a history of breast cancer with positive lymph nodes, for which she received adjuvant chemotherapy and combined hormonal therapy following mastectomy. She underwent surgical excision of the skull mass. Histology confirmed a poorly differentiated carcinoma of unknown origin. A fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT scan revealed an avid 2 cm mass on the left kidney

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“…St. Bartholomew's Hospital and The Royal Free Hospital are specialist cancer centres in London [3]. Both hospitals have introduced telephone-based telemedicine clinics (teleclinics) during the initial weeks of the pandemic to ensure continuity of care whilst reducing risk for cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Learning from Crisis: a Multicentre Study of Oncology Telemedicine Clinics Introduced During COVID-19

et al. 2021

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The COVID-19 pandemic has necessitated adaptation of cancer patient care. Oncology patients who contract COVID-19 have poor outcomes. Telemedicine clinics (teleclinics) have been introduced for cancer patients to reduce the risk of horizontal transmission at St. Bartholomew's Hospital and The Royal Free Hospital in London. Teleclinics have become routine in many specialities; however, inclusion in oncology care was not standard prior to the pandemic. A mixed-methods survey was designed and delivered to cancer patients (n = 106) at St. Bartholomew's Hospital and The Royal Free Hospital who had transitioned to teleclinics in March 2020. The survey explored patients' perceptions of this format. In total, 96 (90.5%) patients consented to take part, across a range of tumour types. Overall, respondents reacted favourably to the format of the teleclinics, with 90.6% of respondents (87/96) stating they would utilise teleclinics beyond the pandemic. Additionally, a survey was distributed to clinicians delivering these teleclinics (n = 16) to explore previous training in, perceptions of, and lessons learned from the introduction of telemedicine. Results suggest patients are accepting of teleclinic use for most clinical purposes. Teleclinic implementation affords benefits to cancer patient care both during and after COVID-19, but there is an urgent need for telemedicine education in oncology specialty training.

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Cytoreductive nephrectomy in metastatic renal cell carcinoma: outcome of patients treated with a multidisciplinary, algorithm-driven approach

Cited by 6 publications

References 17 publications

Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study

Lifestyle and Clinical Factors in a Nationwide Stage III and IV Renal Cell Carcinoma Study

Management of Metastatic Nonclear Renal Cell Carcinoma: What Are the Options and Challenges?

Learning from Crisis: a Multicentre Study of Oncology Telemedicine Clinics Introduced During COVID-19

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