Nephrectomy Followed by Interferon Alfa-2b Compared with Interferon Alfa-2b Alone for Metastatic Renal-Cell Cancer
Robert C. Flanigan, M.D., Sydney E. Salmon, M.D., Brent A. Blumenstein, Ph.D., Scott I. Bearman, M.D., Vivek Roy, M.D., Patrick C. McGrath, M.D., John R. Caton, Jr., M.D., Nikhil Munshi, M.D., and E. David Crawford, M.D.
Background The value of nephrectomy in metastatic renal-cellcancer has long been debated. Several nonrandomized studiessuggest a higher rate of response to systemic therapy and longersurvival in patients who have undergone nephrectomy.
Methods We randomly assigned patients with metastatic renal-cellcancer who were acceptable candidates for nephrectomy to undergoradical nephrectomy followed by therapy with interferon alfa-2bor to receive interferon alfa-2b therapy alone. The primaryend point was survival, and the secondary end point was a responseof the tumor to treatment.
Results The median survival of 120 eligible patients assignedto surgery followed by interferon was 11.1 months, and amongthe 121 eligible patients assigned to interferon alone it was8.1 months (P=0.05). The difference in median survival betweenthe two groups was independent of performance status, metastaticsite, and the presence or absence of a measurable metastaticlesion.
Conclusions Nephrectomy followed by interferon therapy resultsin longer survival among patients with metastatic renal-cellcancer than does interferon therapy alone.
Source Information
From the Loyola University Stritch School of Medicine, Maywood, Ill. (R.C.F.); the University of Arizona Cancer Center, Tucson (S.E.S.); the Southwest Oncology Group Statistical Center, Seattle (B.A.B.); the University of Colorado, Denver (S.I.B., E.D.C.); the University of Oklahoma Health Science Center, Oklahoma City (V.R.); the University of Kentucky Medical Center, Lexington (P.C.M.); Brook Army Medical CenterWilford Hall Medical Center, San Antonio, Tex. (J.R.C.); and the University of Arkansas for Medical Sciences, Little Rock (N.M.).
Address reprint requests to the Southwest Oncology Group (SWOG-8949), Operations Office, 14980 Omicron Dr., San Antonio, TX 78245-3217, or at rflanig{at}luc.edu.
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