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Organo Oficial de la Sociedad Mexicana de Urología

2022, Number 3

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Rev Mex Urol 2022; 82 (3)

Role of cytoreductive nephrectomy in Latin America: from CARMENA to COVID 19

Barreto-Gutiérrez M, Silva-Araujo HD, Fiorella-Saporito DN, Neffa-DellaValle MF, Clavijo-Eisele J, Martínez-Carrancio LA, Autrán-Gómez AM

Language: Spanish
References: 11
Page:
PDF size: 349.33 Kb.


ABSTRACT

Introduction: Metastatic kidney cancer continues to be a therapeutic challenge for urologies and oncologies. With the new systemic therapies, the indication for initial cytoreductive nephrectomy is becoming increasingly controversial. The treatment of the primary tumor at a stage with systemic involvement continues to be a controversial issue.
Materials and Methods: By conducting a survey of Latin American hospitals, this publication aims to evaluate the indication for cytoreductive nephrectomy, the preferred surgical technique and the results obtained, estimating regional therapeutic lines. Online survey was made, based on the most important topics of discussion on cytoreductive nephrectomy and metastatic kidney cancer.
Results: A total of 20 centers participated on the survey, al of them affirmatively about the realization of cytoreductive nephrectomy. Most of them also offer systemic treatment. Regarding the surgical technique used, most used minimally invasive techniques.
Discussion: The international evidence about the role of cytoreductive nephrectomy in this context is varied and subject to permanent change. Individualized treatment, multidisciplinary team are fundamental for the approach of these patients.
Conclusions: The subgroup of patients with metastatic kidney cancer is conceptually heterogeneous. Cytoreductive nephrectomy continues to play an important role, sometimes leading role, in the management of selected patients.


REFERENCES

  1. Capitanio U, Bensalah K, Bex A, Boorjian SA,Bray F, Coleman J, et al. Epidemiology of RenalCell Carcinoma. Eur Urol. 2019 Jan;75(1):74–84. doi: https://doi.org/10.1016/j.eururo.2018.08.036

  2. Comisión Honoraria de Lucha contra elCáncer. Situación Epidemiológica del Uruguayen relación al Cáncer - Mayo 2022. ComisiónHonoraria de Lucha contra el Cáncer. 2022.[accessed 24 Jun 2022] Available from:https://www.comisioncancer.org.uy/Ocultas/Situacion-Epidemiologica-del-Uruguay-enrelacion-al-Cancer--Mayo-2022-uc108

  3. Mickisch GH, Garin A, van Poppel H, dePrijck L, Sylvester R, European Organisationfor Research and Treatment of Cancer(EORTC) Genitourinary Group. Radicalnephrectomy plus interferon-alfa-basedimmunotherapy compared with interferonalfa alone in metastatic renal-cell carcinoma:a randomised trial. Lancet Lond Engl. 2001Sep 22;358(9286):966–70. doi: https://doi.org/10.1016/s0140-6736(01)06103-7

  4. Flanigan RC, Salmon SE, Blumenstein BA,Bearman SI, Roy V, McGrath PC, et al.Nephrectomy followed by interferon alfa-2bcompared with interferon alfa-2b alone formetastatic renal-cell cancer. N Engl J Med.2001 Dec 6;345(23):1655–9. doi: 10.1056/NEJMoa003013

  5. Mejean A, Escudier B, Thezenas S, BeauvalJ-B, Geoffroy L, Bensalah K, et al. CARMENA:Cytoreductive nephrectomy followed bysunitinib versus sunitinib alone in metastaticrenal cell carcinoma—Results of a phase IIInoninferiority trial. J Clin Oncol. 2018 Jun20;36(18_suppl):LBA3–LBA3. doi: http://dx.doi.org/10.1200/JCO.2018.36.18_suppl.LBA3

  6. Bex A, Mulders P, Jewett M, Wagstaff J, vanThienen JV, Blank CU, et al. Comparisonof Immediate vs Deferred CytoreductiveNephrectomy in Patients With SynchronousMetastatic Renal Cell Carcinoma ReceivingSunitinib: The SURTIME Randomized ClinicalTrial. JAMA Oncol. 2019 Feb 1;5(2):164–70. doi:https://doi.org/10.1001/jamaoncol.2018.5543

  7. Bernstein A, Kutikov A. El Papel Contemporáneode la Nefrectomía Citorreductora: Este CarpeDiem cumple con El Primum Non Nocere. AUANEWS Span Ed. 2021;14(3):1–3.

  8. Bakouny Z, Xie W, Dudani S, Wells C, Gan CL,Donskov F, et al. Cytoreductive nephrectomy(CN) for metastatic renal cell carcinoma(mRCC) treated with immune checkpointinhibitors (ICI) or targeted therapy (TT): Apropensity score-based analysis. J Clin Oncol.2020 Feb 20;38(6_suppl):608–608. doi: https://doi.org/10.1200/JCO.2020.38.6_suppl.608

  9. NCCN. COVID-19 Resources. NationalComprehensive Cancer Network. [accessed 24Jun 2022] Available from: https://www.nccn.org/covid-19

  10. EAU. COVID-19 Recommendations by EAUGuidelines panels - Uroweb. Uroweb - EuropeanAssociation of Urology. [accessed 24 Jun 2022]Available from: https://uroweb.org/news/covid-19-recommendations-by-eau-guidelinespanels

  11. Motzer RJ, Rini BI, McDermott DF, ArénFrontera O, Hammers HJ, Carducci MA,et al. Nivolumab plus ipilimumab versussunitinib in first-line treatment for advancedrenal cell carcinoma: extended follow-up ofefficacy and safety results from a randomised,controlled, phase 3 trial. Lancet Oncol.2019 Oct;20(10):1370–85. doi: https://doi.org/10.1016/s1470-2045(19)30413-9




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