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      2021 대한비뇨기종양학회 신암연구회 Consensus Statement: 전이성 신세포암의 종양감축 신적출술 = 2021 Consensus Statements on the Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma From the Korean Renal Cancer Study Group (KRoCS)

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      https://www.riss.kr/link?id=A108244564

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      다국어 초록 (Multilingual Abstract)

      Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC).Materials and Methods: A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC.Results: The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority.Conclusions: In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.
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      Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC).Materials and Methods: A group of mRCC experts from the Kore...

      Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC).Materials and Methods: A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC.Results: The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority.Conclusions: In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.

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      참고문헌 (Reference)

      1 Manley BJ, "Validation of preoperative variables and stratification of patients to help predict benefit of cytoreductive nephrectomy in the targeted therapy ERA" 43 : 432-439, 2017

      2 Conti SL, "Utilization of cytoreductive nephrectomy and patient survival in the targeted therapy era" 134 : 2245-2252, 2014

      3 Bex A, "Updated European Association of Urology Guidelines for cytoreductive nephrectomy in patients with synchronous metastatic clear-cell renal cell carcinoma" 74 : 805-809, 2018

      4 Powles T, "The outcome of patients treated with sunitinib prior to planned nephrectomy in metastatic clear cell renal cancer" 60 : 448-454, 2011

      5 Choueiri TK, "The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy" 185 : 60-66, 2011

      6 Bedke J, "The 2021 Updated European Association of Urology Guidelines on renal cell carcinoma : immune checkpoint inhibitor-based combination therapies for treatment-naive metastatic clear-cell renal cell carcinoma are standard of care" 80 : 393-397, 2021

      7 Hudes G, "Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma" 356 : 2271-2281, 2007

      8 Bhindi B, "Systematic review of the role of cytoreductive nephrectomy in the targeted therapy era and beyond : an individualized approach to metastatic renal cell carcinoma" 75 : 111-128, 2019

      9 De Groot S, "Survival in patients with primary metastatic renal cell carcinoma treated with sunitinib with or without previous cytoreductive nephrectomy : results from a populationbased registry" 95 : 121-127, 2016

      10 Marchioni M, "Survival after cytoreductive nephrectomy in metastatic non-clear cell renal cell carcinoma patients : a population-based study" 5 : 488-496, 2019

      1 Manley BJ, "Validation of preoperative variables and stratification of patients to help predict benefit of cytoreductive nephrectomy in the targeted therapy ERA" 43 : 432-439, 2017

      2 Conti SL, "Utilization of cytoreductive nephrectomy and patient survival in the targeted therapy era" 134 : 2245-2252, 2014

      3 Bex A, "Updated European Association of Urology Guidelines for cytoreductive nephrectomy in patients with synchronous metastatic clear-cell renal cell carcinoma" 74 : 805-809, 2018

      4 Powles T, "The outcome of patients treated with sunitinib prior to planned nephrectomy in metastatic clear cell renal cancer" 60 : 448-454, 2011

      5 Choueiri TK, "The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy" 185 : 60-66, 2011

      6 Bedke J, "The 2021 Updated European Association of Urology Guidelines on renal cell carcinoma : immune checkpoint inhibitor-based combination therapies for treatment-naive metastatic clear-cell renal cell carcinoma are standard of care" 80 : 393-397, 2021

      7 Hudes G, "Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma" 356 : 2271-2281, 2007

      8 Bhindi B, "Systematic review of the role of cytoreductive nephrectomy in the targeted therapy era and beyond : an individualized approach to metastatic renal cell carcinoma" 75 : 111-128, 2019

      9 De Groot S, "Survival in patients with primary metastatic renal cell carcinoma treated with sunitinib with or without previous cytoreductive nephrectomy : results from a populationbased registry" 95 : 121-127, 2016

      10 Marchioni M, "Survival after cytoreductive nephrectomy in metastatic non-clear cell renal cell carcinoma patients : a population-based study" 5 : 488-496, 2019

      11 Thomas AA, "Surgical resection of renal cell carcinoma after targeted therapy" 182 : 881-886, 2009

      12 Motzer RJ, "Sunitinib versus interferon alfa in metastatic renal-cell carcinoma" 356 : 115-124, 2007

      13 Méjean A, "Sunitinib alone or after nephrectomy in metastatic renal-cell carcinoma" 379 : 417-427, 2018

      14 Méjean A, "Sunitinib alone or after nephrectomy for patients with metastatic renal cell carcinoma : is there still a role for cytoreductive nephrectomy?" 80 : 417-424, 2021

      15 Escudier B, "Sorafenib in advanced clear-cell renal-cell carcinoma" 356 : 125-134, 2007

      16 Powles T, "Safety and efficacy of pazopanib therapy prior to planned nephrectomy in metastatic clear cell renal cancer" 2 : 1303-1309, 2016

      17 Chiong E, "Role of cytoreductive nephrectomy in renal cell carcinoma" 5 : 859-869, 2009

      18 Thomas AA, "Response of the primary tumor to neoadjuvant sunitinib in patients with advanced renal cell carcinoma" 181 : 518-523, 2009

      19 Motzer RJ, "Renal-cell carcinoma" 335 : 865-875, 1996

      20 Griffioen AW, "Rapid angiogenesis onset after discontinuation of sunitinib treatment of renal cell carcinoma patients" 18 : 3961-3971, 2012

      21 Mickisch GH, "Radical nephrectomy plus interferonalfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma : a randomised trial" 358 : 966-970, 2001

      22 Heng DY, "Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents : results from a large, multicenter study" 27 : 5794-5799, 2009

      23 Klatte T, "Prognostic effect of cytoreductive nephrectomy in synchronous metastatic renal cell carcinoma : a comparative study using inverse probability of treatment weighting" 36 : 417-425, 2018

      24 Fukuda H, "Predictive value of inflammation-based prognostic scores in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy" 9 : 14296-14305, 2018

      25 Rini BI, "Pembrolizumab plus axitinib versus sunitinib for advanced renal-cell carcinoma" 380 : 1116-1127, 2019

      26 Soulières D, "Pembrolizumab plus axitinib versus sunitinib as first-line therapy for advanced renal cell carcinoma(RCC) : subgroup analysis from KEYNOTE-426 by prior nephrectomy" 18 : 34-, 2020

      27 Singla N, "Pathologic response and surgical outcomes in patients undergoing nephrectomy following receipt of immune checkpoint inhibitors for renal cell carcinoma" 37 : 924-931, 2019

      28 Motzer RJ, "Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma" 378 : 1277-1290, 2018

      29 Choueiri TK, "Nivolumab plus cabozantinib versus sunitinib for advanced renalcell carcinoma" 384 : 829-841, 2021

      30 Mathieu R, "Nephrectomy improves overall survival in patients with metastatic renal cell carcinoma in cases of favorable MSKCC or ECOG prognostic features" 33 : 339-, 2015

      31 Flanigan RC, "Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer" 345 : 1655-1659, 2001

      32 Motzer RJ, "NCCN guidelines insights: kidney cancer, version 1.2021" 18 : 1160-1170, 2020

      33 Shin TJ, "Metastatic renal cell carcinoma to the pancreas : clinical features and treatment outcome" 123 : 204-213, 2021

      34 Motzer R, "Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma" 384 : 1289-1300, 2021

      35 Mason RJ, "Kidney Cancer Research Network of Canada(KCRNC)consensus statement on the role of cytoreductive nephrectomy for patients with metastatic renal cell carcinoma" 13 : 166-174, 2019

      36 Singla N, "Improved survival after cytoreductive nephrectomy for metastatic renal cell carcinoma in the contemporary immunotherapy era : an analysis of the National Cancer Database" 38 : 604-, 2020

      37 McLaughlin JK, "Epidemiologic aspects of renal cell carcinoma" 33 : 527-533, 2006

      38 Tannir NM, "Efficacy and safety of nivolumab plus ipilimumab versus sunitinib in first-line treatment of patients with advanced sarcomatoid renal cell carcinoma" 27 : 78-86, 2021

      39 Abel EJ, "Early primary tumor size reduction is an independent predictor of improved overall survival in metastatic renal cell carcinoma patients treated with sunitinib" 60 : 1273-1279, 2011

      40 Adashek JJ, "Dissecting outcomes : should cytoreductive nephrectomy be performed for patients with metastatic renal cell carcinoma with sarcomatoid dedifferentiation?" 10 : 627025-, 2021

      41 Bhindi B, "Deferred cytoreductive nephrectomy in patients with newly diagnosed metastatic renal cell carcinoma" 78 : 615-623, 2020

      42 De Bruijn R, "Deferred cytoreductive nephrectomy following presurgical vascular endothelial growth factor receptor-targeted therapy in patients with primary metastatic clear cell renal cell carcinoma : a pooled analysis of prospective trial data" 3 : 168-173, 2020

      43 Bakouny Z, "Cytoreductive nephrectomy(CN)for metastatic renal cell carcinoma(mRCC)treated with immune checkpoint inhibitors(ICI)or targeted therapy(TT) : a propensity score-based analysis" 38 (38): 608-, 2020

      44 Heng DYC, "Cytoreductive nephrectomy in patients with synchronous metastases from renal cell carcinoma : results from the international metastatic renal cell carcinoma database consortium" 66 : 704-710, 2014

      45 Aizer AA, "Cytoreductive nephrectomy in patients with metastatic non-clear-cell renal cell carcinoma(RCC)" 113 : E67-E74, 2014

      46 Shuch B, "Cytoreductive nephrectomy for kidney cancer with sarcomatoid histology--is up-front resection indicated and, if not, is it avoidable?" 182 : 2164-2171, 2009

      47 Poon DM, "Consensus statements on the management of metastatic renal cell carcinoma from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology 2019" 17 (17): 27-38, 2021

      48 Bex A, "Comparison of immediate vs deferred cytoreductive nephrectomy in patients with synchronous metastatic renal cell carcinoma receiving sunitinib : the SURTIME randomized clinical trial" 5 : 164-170, 2019

      49 Macleod LC, "Comparative effectiveness of initial surgery vs initial systemic therapy for metastatic kidney cancer in the targeted therapy era : analysis of a population-based cohort" 113 : 146-152, 2018

      50 강미주 ; 원영주 ; 이재준 ; 정규원 ; 김혜진 ; 공현주 ; 임정수 ; 서홍관, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2019" 대한암학회 54 (54): 330-344, 2022

      51 Motzer RJ, "Avelumab plus axitinib versus sunitinib for advanced renal-cell carcinoma" 380 : 1103-1115, 2019

      52 Siemer S, "Adrenal metastases in 1635 patients with renal cell carcinoma : outcome and indication for adrenalectomy" 171 : 2155-2159, 2004

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      연월일 이력구분 이력상세 등재구분
      2026 평가예정 재인증평가 신청대상 (재인증)
      2020-01-01 평가 등재학술지 유지 (재인증) KCI등재
      2017-01-01 평가 등재학술지 선정 (계속평가) KCI등재
      2015-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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