Role of cytoreductive nephrectomy in metastatic medullary renal cell carcinoma: controlled analysis.

Authors

Quynh Chi Le, Andrea Marmiroli, Mattia Longoni, Fabian Falkenbach, Calogero Catanzaro, Michele Nicolazzini, Federico Polverino, Jordan A Goyal, Fred Saad, Riccardo Schiavina, Luca Fabio Carmignani, Alberto Briganti, Nicola Longo, Markus Graefen, Carlotta Palumbo, Carolin Siech, Severine Banek, Miriam Traumann, Felix K-H Chun, Pierre I Karakiewicz

Published in

World journal of urology. Volume 44. Issue 1. Sep 19, 2026. Epub Sep 19, 2026.

Abstract

To test for differences in overall survival (OS) according to cytoreductive nephrectomy (CN) in medullary metastatic renal cell carcinoma (med-mRCC) relative to most comparable clear cell metastatic RCC (cc-mRCC) patients.
Within the Surveillance, Epidemiology and End Results (SEER) database (2000-2021), we identified 62 patients with med-mRCC vs. 10,372 with cc-mRCC. Propensity score matching (PSM, ratio 1:3), Kaplan-Meier plots and multivariable Cox regression analyses addressed were used.
Of 10,434 patients, 62 (0.6%) harbored med-mRCC vs. 10,372 (99.4%) cc-mRCC. Med-mRCC patients were younger (27 vs. 63 years, p < 0.001), more frequently African American (74 vs. 6%, p < 0.001) and more frequently harbored N1 stages (52 vs. 28%, p < 0.001). After 1:3 PSM for age, race/ethnicity, T-stage and N-stage, 62 of 62 (100%) med-mRCC (median OS 4 months) and 186 of 10,372 (2%) cc-mRCC patients (median OS 10 months) remained for further analyses. In med-mRCC, median OS was 9 months with CN vs. 3 months without CN (p = 0.01). In cc-mRCC, median OS was 28 months with CN vs. 5 months without CN (p < 0.001). In med-mRCC, CN independently predicted better OS (Hazard's Ratio [HR] 0.5, p = 0.005), as well as in cc-mRCC (HR 0.4, p < 0.001).
Med-mRCC patients exhibit a drastically different phenotype relative to their cc-mRCC counterparts. Despite this difference, med-mRCC exposed to CN harbor a similar relative protective survival effect compared to their cc-mRCC counterparts with most comparable age, race/ethnicity and tumor characteristics.

PMID:
42762265
Bibliographic data and abstract were imported from PubMed on 20 Sep 2026.

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