Surgical Safety of Cytoreductive Nephrectomy Following Sunitinib: Results from the Multicentre, Randomised Controlled Trial of Immediate Versus Deferred Nephrectomy (SURTIME)

Roderick Emile De Bruijn, Peter Mulders, Michael A. Jewett, John Wagstaff, Johan V. Van Thienen, Christian U. Blank, Roland Van Velthoven, Lori Wood, Harm E. van Melick, Maureen J. Aarts, Jean B. Lattouf, Thomas Powles, Igle J. De Jong, Sylvie Rottey, Betrand Tombal, Sandrine Marreaud, Sandra Collette, Laurence Collette, John B. Haanen, Axel Bex*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)

Abstract

The European Organisation for Research and Treatment of Cancer SURTIME trial explored timing of sunitinib, a tyrosine kinase inhibitor (TKI), and cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma. Previous retrospective studies suggest increased surgeryrelated adverse events (AEs) after presurgical TKI. We report surgical safety from a randomised comparison of CN before or after sunitinib. In-hospital mortality, 30-d readmission rate, and intraoperative and 30-d postoperative AEs according to Common Terminology Criteria for Adverse Events version 4 and Clavien-Dindo (CD) were analysed. Patients were randomised 1:1 to immediate CN followed by sunitinib versus sunitinib followed by deferred CN 24 h after the last dose of sunitinib. None of the tumours in the deferred arm became unresectable, and only two patients had a sunitinib-related delay of CN of >2 wk. AEs related to surgery (all grades) in the immediate and deferred arms occurred in 52% and 53% after CN, respectively, although the number of intraoperative surgery-related AEs was higher in the immediate arm. Postoperative AEs (CD >= 3), 30-d readmission, and in-hospital mortality rates were 6.5%, 13%, and 4.3% in the immediate arm and 2.5%, 7.5%, and 2.5% in the deferred arm, respectively. There were no differences in surgery time, blood loss, and hospital stay.

Patient summary: Patients with metastatic kidney cancer do not have more surgical complications irrespective of whether they are treated with systemic therapy before or after surgery. (C) 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)437-440
Number of pages4
JournalEuropean Urology
Volume76
Issue number4
Early online date18-Jun-2019
DOIs
Publication statusPublished - Oct-2019

Keywords

  • Renal cell carcinoma
  • Cytoreductive nephrectomy
  • Surgical safety
  • RENAL-CELL CARCINOMA
  • PLANNED NEPHRECTOMY
  • EFFICACY
  • THERAPY

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