# Long‐term outcomes after cytoreductive partial nephrectomy for metastatic renal cell carcinoma

## TL;DR

This study examines long-term outcomes of cytoreductive partial nephrectomy in metastatic kidney cancer patients, finding acceptable survival and kidney function preservation.

## Contribution

The study provides long-term survival data and evaluates patient selection for CRPN in metastatic renal cell carcinoma.

## Key findings

- Median overall survival was 6.1 years with acceptable surgical complications.
- Larger tumor size was linked to higher cancer-specific death risk.
- Renal function was preserved without dialysis after surgery.

## Abstract

To assess treatment outcomes and evaluate patient selection criteria for cytoreductive partial nephrectomy (CRPN) in a unique cohort of metastatic renal cell carcinoma (mRCC) patients.

A retrospective review of mRCC patients who underwent CRPN between 1995 and 2023 at a single institution was performed. Clinical characteristics, perioperative outcomes, longitudinal imaging reports and overall survival data were analysed.

Seventy‐three patients with mRCC were included. Forty per cent of patients had prior radical nephrectomy, and 44% had prior metastasectomy. The median tumour size was 4 cm (IQR 2.7, 5.5). Median follow‐up among patients who survived was 6.7 years (IQR 3.4, 9.6). Median overall survival was 6.1 years (95% CI 4.6 to 7.8). Complications occurred in 22% of patients within 30 days post‐surgery. eGFR stabilized at 3 months after surgery, and no patients required dialysis. Larger tumour size was associated with a higher risk of cancer‐specific death (HR 1.19, 95% CI 1.07 to 1.31, p < 0.001). Higher pathologic stage and grade were associated with significantly higher risks of cancer‐specific death (HR 2.78, 95% CI 0.83 to 9.36, p = 0.10 and HR 1.45, 95% CI 0.64 to 3.29, p = 0.4, respectively).

CRPN was performed effectively as a component of integrated medical and surgical management for highly selected mRCC patients. Preservation of renal function in patients with a solitary kidney or with an intact contralateral kidney was achieved with acceptable surgical morbidity and oncologic outcomes.