Evidence map›Paper›PMID 39066794›Full record

ArticleWorld journal of urology2024

Upfront versus deferred cytoreductive nephrectomy following targeted or immunotherapy: a population-based propensity score-matched analysis of perioperative complications.

Francesco Ditonno, Eugenio Bologna, Leslie Claire Licari, Antonio Franco, Greta Pettenuzzo, Costantino Leonardo, Flavia Proietti, Umberto Carbonara, M Carmen Mir, Simone Crivellaro and 4 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
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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

14 authors.

Francesco Ditonno *Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.
Eugenio Bologna *Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.
Leslie Claire LicariDepartment of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.
Antonio FrancoDepartment of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.
Greta PettenuzzoDepartment of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Costantino LeonardoDepartment of Urology, "Regina Elena" National Cancer Institute, Rome, Italy.
Flavia ProiettiDepartment of Urology, "Regina Elena" National Cancer Institute, Rome, Italy.
Umberto CarbonaraDepartment of Urology, Royal Surrey HNS Trust, Guildford, UK.
M Carmen MirDepartment of Urology, Hospital Universitario La Ribera, Valencia, Spain.
Simone CrivellaroDepartment of Urology, University of Illinois at Chicago, Chicago, IL, USA.
Alessandro VecciaDepartment of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Riccardo BertoloDepartment of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Alessandro AntonelliDepartment of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Riccardo AutorinoDepartment of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA. ricautor@gmail.com.ORCID http://orcid.org/0000-0001-7045-7725

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the incidence of postoperative complications after cytoreductive nephrectomy (CN) following first-line treatment for metastatic renal cell carcinoma (mRCC), and to compare it with postoperative complications of upfront CN.

methodsFor this population-based retrospective study, the PearlDiver Mariner database (PearlDiver Technologies, Colorado Springs, CO), a database of insurance billing records was analyzed. Using relevant ICD-9/10 and CPT codes, patients diagnosed with mRCC between 2011 and 2021, who received first-line systemic molecular therapy (SMT), either tyrosine kinase inhibitors (TKI) or immune-checkpoint inhibitors (ICI), were identified. The selected population was stratified into two cohorts according to the timing of CN (deferred: after SMT vs. upfront: before SMT). Propensity-score matching (PSM) was performed as per baseline patients' characteristics to control for potential confounders between the two cohorts. The primary outcome was to compare 30-day postoperative complications rate between patients undergoing upfront vs. deferred CN.

resultsAfter PSM, 162 patients who received upfront CN were compared with 162 patients who underwent deferred CN. The overall rate of 30-day postoperative complications was statistically significantly higher in patients undergoing deferred CN (33.9%), compared to patients treated with upfront CN (21%, p < 0.01). In addition, the rate of both medical (26.5% vs. 14.2%, p < 0.01) and surgical (14.8 vs. 7.4%, p = 0.03) complication rate was statistically significantly higher in deferred vs. upfront CN. Multivariable logistic regression analysis revealed that none of the treatment regimens significantly predicted the occurrence of postoperative complications.

conclusionPatients undergoing deferred CN experience a higher rates of overall, medical, and surgical 30-day postoperative complications compared to those receiving upfront surgery. Findings from this study should be interpreted within the limitations of this type of analysis.

Indexed as

Carcinoma, Renal CellCytoreduction Surgical ProceduresImmunotherapyKidney NeoplasmsNephrectomyPostoperative ComplicationsPropensity ScoreAgedFemaleHumansIncidenceMaleMiddle AgedMolecular Targeted TherapyRetrospective StudiesCytoreductive surgeryImmune Checkpoint inhibitorsKidney cancerNephrectomyPostoperative complicationsTyrosine kinase inhibitors

Identifiers

PMID39066794

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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.