Evidence map›Paper›PMID 32128610›Full record

ArticleWorld journal of urology2020

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

Wing K Liu, J M Lam, T Butters, M Grant, F Jackson-Spence, A Bex, T Powles, B Szabados

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Article in World journal of urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Cytoreductive nephrectomy in metastatic renal cell carcinoma.The Cochrane database of systematic reviews · 2024
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Wing K Liu *Barts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK.
J M Lam *Barts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK.
T ButtersBarts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK.
M GrantBarts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK.
F Jackson-SpenceBarts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK.
A BexUCL Division of Surgery and Interventional Science, Renal Cancer Unit, Royal Free Hospital, London, UK.
T PowlesBarts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK. Thomas.powles1@nhs.net.
B SzabadosBarts and The London School of Medicine and Dentistry, Barts Cancer Institute, Queen Mary University of London, London, UK.
Queen Mary University of London · GBThe Royal Free Hospital · GBUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMetastatic renal cell carcinoma (mRCC) represents a significant and rising burden of disease, with rapidly evolving treatment modalities. The role of cytoreductive nephrectomy (CN) is controversial in this setting. As such, London Cancer has pursued a multidisciplinary team (MDT) approach when assessing suitability for surgery.

methodsA retrospective analysis of treatment-naive synchronous mRCC patients, managed via a renal-specialist MDT, was conducted between January 2015 and December 2018. An MDT selection algorithm for CN-using the International Metastatic Renal Cell Carcinoma Database Consortium score (IMDC), performance status and metastatic disease burden-was developed.

results87 treatment-naive synchronous mRCC patients received either CN (n = 18), Systemic therapy (ST) alone (n = 43) or Best supportive care (BSC) (n = 26). Progression free survival (PFS) and overall survival (OS) were assessed. 51% and 39% were IMDC intermediate and poor risk. Median PFS was 28.6 months and 4.5 months in the CN group and ST alone group, respectively, Hazard Ratio for death was 3.63 [(95% CI 1.68-7.83) p < 0.05]. OS remains immature for the CN group, but a median OS of 12.8 months was observed in the ST group and 5.0 months for BSC. 1-year OS rate for CN, ST and BSC groups was 77.8%, 55.8% and 23.10%, respectively.

conclusionThese findings describe outcomes of an unselected series of patients treated via an MDT-driven, protocolised treatment pathway. MDT pathway-based decision making may improve patient selection for CN. Further research is needed to evaluate the role of CN amongst a growing landscape of treatment strategies, including immune checkpoint inhibitors and combination therapies. Multi-disciplinary team, pathway-based treatment strategy may improve patient selection for cytoreductive nephrectomy in patients with metastatic renal cell carcinoma.

Indexed as

AlgorithmsCytoreduction Surgical ProceduresAdultAgedAged, 80 and overCarcinoma, Renal CellFemaleHumansKidney NeoplasmsMaleMiddle AgedNephrectomyPatient Care TeamRetrospective StudiesCytoreduction surgical proceduresNephrectomyRenal cell carcinomaSurgical safety

Identifiers

PMID32128610
OpenAlexW3010114921

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.