Investigation of the IMDC prognostic model as a predictor of outcome from cytoreductive nephrectomy in metastatic renal cell carcinoma
BAUS ePoster online library. Hendry J. Jun 27, 2018; 211388
Ms. Jane Hendry
Ms. Jane Hendry
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Abstract
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Introduction: Selecting patients with metastatic renal cell carcinoma (mRCC) for cytoreductive nephrectomy (CN) can be difficult. The International mRCC Database Consortium Prognostic Model (IMDC-M) aids stratification of patients for systemic therapy and has been shown to be prognostic in patients presenting initially with mRCC. We aimed to determine if the IMDC-M predicts outcome following CN.

Methods: Clinical data from 250 patients presenting with mRCC between 2001-2017 were collected retrospectively. IMDC-M stratification was calculated for each patient, when sufficient data was available. Comparisons and survival analysis was performed using SPSS.

Results: Sufficient data was currently available for 215 patients (86(40%) IMDC-M intermediate risk [IR] and 129(60%) IMDC-M poor risk [PR]). CN was performed in 110(51.1%) patients and was performed more commonly in IR patients than PR patients (65% and 42%, p<0.001). While there was a greater overall survival (OS) in patients undergoing CN with IR compared to PR (p<0.001), there was significantly improved median OS in those patients undergoing CN compared to those without CN in both IR (28 months and 12 months, p<0.001) and PR (14 months and 3 months, p<0.001) patients. IMDC-M, and CN were both predictive of OS on multivariate cox regression analysis.

Conclusion: We have validated the prognostic utility of the IMDC-M in patients presenting with mRCC, which may prove useful for counseling patients. However, this prognostic tool should not be used alone for predicting outcome after CN, as CN may have an OS benefit in all risk groups. Further work investigating additional predictive parameters of outcome from CN is ongoing.

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