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Impact of Bone Metastases on Surgical Outcomes in Metastatic Kidney Cancer

By: Julia Fiederlein
Posted: Friday, January 29, 2021

According to Juan Javier-DesLoges, MD, MS, of UC San Diego Health, La Jolla, California, and colleagues, the presence of bone metastases at the time of cytoreductive radical nephrectomy does not seem to independently impact survival or oncologic outcomes in patients with metastatic renal cell carcinoma. The results of this multicenter, retrospective review were presented during the virtual edition of the 2020 Society of Urologic Oncology (SUO) Annual Meeting (Abstract 84).

“The presence of brain metastases and bone metastases are generally understood to herald worsened prognosis following nephrectomy in patients with renal cell carcinoma,” the investigators explained. “While further validation is needed, the prognostic significance of bone metastases at [the] time of cytoreductive nephrectomy may overall be less than previously thought.”

The investigators focused on patients with (n = 124) and without (n = 323) bone metastases who underwent cytoreductive radical nephrectomy between 2004 and 2018. Based on Kaplan-Meier analyses, the durations of progression-free (25.5 vs. 27.4 months; P = .958) and overall (7.0 vs. 6.2 months; P = .973) survival at 5 years did not seem to differ between patients with and without bone metastases, respectively. However, differences in the durations of overall survival were observed among patients with low-, intermediate-, and high-risk disease (P = .001); but overall and progression-free survival outcomes did not appear to significantly differ in patients with intermediate- or high-risk disease with or without bone metastases.

Cox regression analyses demonstrated that age, sex, body mass index, Eastern Cooperative Oncology Group performance status score, pathologic upstaging, positive surgical margins, intraoperative complications, and the presence of bone metastases did not seem to be independently associated with progression-free survival. However, positive surgical margins did appear to be significantly associated with worsened overall survival (odds ratio = 2.030; P = .005).

Disclosure: No information regarding conflicts of interest was provided.



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