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A recent study looked at whether the use of cytoreductive nephrectomy (CN) has changed in the USA after the publication of the results from the CARMENA trial in 2018. For decades, the immediate surgical removal of the kidney tumour (cytoreductive nephrectomy) was the first treatment for metastatic kidney cancer. In 2018, the CARMENA study showed that patients treated with anti-cancer medication alone had similar outcomes to patients who had a cytoreductive nephrectomy first.
Cytoreductive nephrectomy is a surgical procedure to remove all or part of the kidney to treat metastatic kidney cancer. The term ‘cytoreductive’ refers to the goal of reducing the number of cancer cells, while ‘nephrectomy’ refers to the surgical removal of a kidney.
In this study patients with metastatic kidney cancer were identified from the US National Cancer Database from 2004 to 2020. Researchers looked at the change in the number of cytoreductive nephrectomies in patients with metastatic clear cell kidney cancer diagnosed before and after 2018.
The study found that the number of cytoreductive nephrectomies decreased significantly after the publication of the CARMENA trial in 2018, with a very small difference between regions or patient characteristics. Overall, the publication of the CARMENA trial results seems to be associated with big change in clinical practice in the USA, with the practice being used across facilities, regions, and patient demographics.
This study shows that fewer cytoreductive nephrectomies were performed in the US after the CARMENA trial results were published.