Current trends in cytoreductive nephrectomy in the era of targeted molecular therapy (2017)

Type of publication:
Conference abstract

*Phan Y.; *Segaran S.; *Bell J.; *Nakada S.Y.; *Rane A.

Journal of Endourology; Sep 2017; vol. 31, S2

Introduction & Objective: Several factors are considered when determining if a patient is a candidate for
cytoreductive nephrectomy (CN). Our aim was to study geographic trends and factors associated with the decision to consider CN. Materials and Methods: An investigator designed survey was created to assess the rate of CN being performed around the world and the factors considered when determining patient eligibility. This was distributed to attendees at the World Congress of Endourology 2016 in Cape Town in order to capture an international cohort of urologists. The survey included questions about physician demographics, the timing of CN, what patient factors were considered prior performing CN, and if they followed any guidelines when deciding on CN. Results: 158 urologists responded to our survey (Asia = 46, Europe = 35, Africa = 34, North America = 29, South America = 13 and Australia = 1). 78 (49.4%) urologists indicated that they follow guidelines for recommending CN. 107 (67.7%) of respondents stated they perform CN. 64 urologists perform CN prior to systemic therapy while 20 urologists perform CN after systemic treatment, and 22 urologists perform CN before or after systemic treatment. Performance status was the most considered factor while calcium level was the least considered factor when determining eligibility for CN. Conclusions: This cohort of urologists most commonly consider performance status, age and extent of metastatic disease when determining candidacy for CN; while the grade of the tumour and the calcium level were the least considered. We eagerly await the results of CARMENA and SURTIME trials.