Evidence map›Paper›PMID 35314918›Full record

ArticleInternational urology and nephrology2022

Prognostic model of upfront cytoreductive nephrectomy in patients with metastatic renal cell carcinoma treated with immune checkpoint inhibitors and/or targeted agents.

Jun Teishima, Keisuke Goto, Yohei Sekino, Koji Mita, Tetsutaro Hayashi, Yasuhisa Hasegawa, Masao Kato, Mitsuru Kajiwara, Masanobu Shigeta, Satoshi Maruyama and 5 more

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Article in International urology and nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Role of Cytoreductive Nephrectomy in the Immune Checkpoint Inhibitor Era: A Multicenter Collaborative Study.International journal of urology : official journal of the Japanese Urological Association · 2025
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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

15 authors.

Jun TeishimaDepartment of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan. teishima@hiroshima-u.ac.jp.
Keisuke GotoDepartment of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Yohei SekinoDepartment of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Koji MitaDepartment of Urology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Tetsutaro HayashiDepartment of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Yasuhisa HasegawaDepartment of Urology, Fukuyama Medical Center, Fukuyama, Japan.
Masao KatoDepartment of Urology, Hiroshima General Hospital, Hatsukaichi, Japan.
Mitsuru KajiwaraDepartment of Urology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Masanobu ShigetaDepartment of Urology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
Satoshi MaruyamaDepartment of Urology, Miyoshi Central Hospital, Miyoshi, Japan.
Yuichi KadonishiDepartment of Urology, Onomichi General Hospital, Onomichi, Japan.
Seiji FujiwaraDepartment of Urology, Higashi-Hiroshima Medical Center, Higashi-Hiroshima, Japan.
Kanao KobayashiDepartment of Urology, Chugoku Rosai Hospital, Kure, Japan.
Kousuke AsanoDepartment of Urology, Hiroshima-Nishi Medical Center, Ohtake, Japan.
Nobuyuki HinataDepartment of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION AND

objectivesThe aim of this study was to investigate prognostic factors and to establish a prognostic model using them for upfront cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitor (ICI) and/or tyrosine kinase inhibitor (TKI). MATERIALS AND

methodsTwo hundred eleven patients who were diagnosed as mRCC at initial diagnosis and were treated with TKI and/or ICI were classified into 2 groups: those undergoing CN (upfront CN group, 117 cases) and those who initially underwent systemic therapy (non-upfront CN group, 94 cases). In the upfront CN group, the patients' background and overall survival (OS) were compared with those in the other two groups, and prognostic factors were analyzed. A prognostic model of the upfront CN group was established.

resultsThe median of the observation period for the upfront CN group was 25 months. The rates of patients with clear cell histology, with a Karnofsky performance status (KPS) of ≥ 80%, with a single metastatic organ, with a normal pretreated C-reactive protein level, and with an intermediate risk according to the International mRCC Database Consortium (IMDC) model were significantly higher than those in the non-upfront CN group (87.2% and 30.9%, p < 0.0001; 92.3% and 77.7%, p = 0.0025; 41.9% and 24.5%, p = 0.0080; 47.9% and 13.8%, p < 0.0001; 66.7% and 45.7%, p = 0.0023, respectively). The 50% OS in the upfront CN group was 33.1 months, significantly better than that in the non-upfront CN group (11.1 months, p < 0.0001), and these results were consistent regardless of their prognostic risk level. Multivariate analysis showed that multiple metastatic organs and a KPS of < 80% were independent predictive factors for OS (hazard ratio: 1.653 and 2.995, p = 0.0339 and 0.0054, respectively). Using these two parameters to stratify the upfront CN group, the 50% OSs in cases with no risk factors, in those with one factor, and in those with two factors were 43.4 months, 29.1 months, and 7.7 months, respectively (p < 0.0001).

conclusionThe upfront CN group was able to be stratified by our prognostic model into three subgroups with different prognoses. This model can provide useful information for making decisions in consideration of upfront CN in patients with mRCC.

Indexed as

Antineoplastic AgentsCarcinoma, Renal CellKidney NeoplasmsCytoreduction Surgical ProceduresFemaleHumansImmune Checkpoint InhibitorsMaleNephrectomyPrognosisProtein Kinase InhibitorsRetrospective StudiesAntineoplastic AgentsImmune Checkpoint InhibitorsProtein Kinase InhibitorsCytoreductive nephrectomyOverall survivalPrognostic factorRenal cell carcinoma

Identifiers

PMID35314918

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