MEDICAL INTELLIGENCE
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26 Kidney Cancer Journal
survey was disseminated in various patient communities
using social media and was posted to the KCCure website
in June 2018 after the presentation of the CARMENA trial.
Patients were asked “The CARMENA trial presented recently
at ASCO found that for kidney cancer patients diagnosed
with metastatic disease, there is no overall survival benefit
of having a nephrectomy prior to starting systemic therapy.
Knowing that information, would you still want to have a
nephrectomy at diagnosis if you were metastatic?”
Patients were also asked whether they had already had
a nephrectomy and their stage at diagnosis and whether
they were on systemic therapy. On the question of whether
they would want nephrectomy 75.2% of the patients indicated
they would still prefer nephrectomy. Of the patients
with primary metastatic disease and the tumor in place
treated with systemic therapy, 20.1% wanted their kidney
tumor to be removed. There was no statistically significant
difference between patients who had experience with
systemic therapy and those who hadn’t, and answers were
also consistent regardless of gender and age. The conclusion
of the authors: Overall survival should not be overestimated
as the most important aim in an end-stage patient
population. Patients might think differently about benefits,
risks and value of surgical procedures than physicians. KCJ
/kidney-cancer-journal.com
