Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Partial vs Radical Nephrectomy Impact on Survival

Eur Urol Focus; ePub 2018 Feb 2; Marchioni, et al

Partial nephrectomy (PN) may help prevent renal insufficiency, hypertension, and other unfavorable health outcomes in older people with nonmetastatic T1a renal cell carcinoma (RCC), according to a study involving >4,500 individuals. Participants were ≥75 years of age with surgically-treated nonmetastatic T1a RCC. Investigators looked at the impact partial vs radical nephrectomy had on other-cause, cancer-specific, and 30-day mortality. Among the results:

  • 42% of patients had partial nephrectomy.
  • Those undergoing partial nephrectomy were 33% less likely than those who had radical nephrectomy to experience other-cause mortality.
  • The favorable outcome was seen across all ages evaluated.
  • Those in the partial nephrectomy group were 36% less likely to experience cancer-specific mortality.
  • 30-day mortality rates did not differ.

Citation:

Marchioni M, Preisser F, Bandini M, et al. Comparison of partial versus radical nephrectomy effect on other-cause mortality, cancer-specific mortality, and 30-day mortality in patients older than 75 years. [Published online ahead of print February 2, 2018]. Eur Urol Focus. doi:10.1016/j.euf.2018.01.007

This Week's Must Reads

Flat pricing of ibrutinib , Sales revenues at the potential expense of patient safety https://cancerletter.com/articles/20180413_5/

Most oncologists discuss medical marijuana with patients, Braun I et al. J Clin Oncol. 2018 May 10. doi: 10.1200/JCO.2017.76.1221.

$800M cut proposed for Centers for Medicare & Medicaid Innovation, Proposed rescission of budget authority https://www.whitehouse.gov/wp-content/uploads/2018/05/POTUS-Rescission-Transmittal-Package-5.8.2018.pdf

Medicare Beneficiary Identifiers required for billing by 2019, New Medicare cards https://www.cms.gov/medicare/new-medicare-card/nmc-home.html

Trump administration unveils drug pricing initiative, American Patients First https://www.hhs.gov/sites/default/files/AmericanPatientsFirst.pdf

Must Reads in Renal Cell Carcinoma

miRNAs are biomarkers for RCC prognosis, Pan X et al. Biomedicine and Pharmacotherapy 102: 2018; 718-27. https://doi.org/10.1016/j.biopha.2018.03.072

Pseudocapsule status predicts RCC prognosis, Xi W et al. The Journal of Urology 199: 2018; 915-20. https://doi.org/10.1016/j.juro.2017.10.043

New model uses histologic subtypes to predict RCC prognosis, Leibovich B et al. European Urology 73; 2018: 772-80. https://doi.org/10.1016/j.eururo.2018.01.005

Histologic similarities in clear cell papillary RCC and tuberous sclerosis, Williamson S et al. Human Pathology 75; 2018: 10-15 https://doi.org/10.1016/j.humpath.2017.11.013

IMDC risk group classification predicts sunitinib response, Rini B et al. Clinical Genitourinary Cancer; published online May 4, 2018 https://doi.org/10.1016/j.clgc.2018.04.005