Summary Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefits and harms of ...various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the findings presented here should be interpreted with caution, they and the identified gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
4540
Background: Given the need to balance both quantity and quality of life among patients with advanced cancer, developing a robust, relevant, and consensus-driven patient-focused measurement ...strategy is a necessity. Our study expands upon previous findings (Bergerot et al., The Oncologist 2023) in evaluating the perceived relevance of questions on the FKSI-19, EORTC QLQ-C30, and EQ-5D among patients with RCC. Methods: Eligible patients were diagnosed with RCC and asked to evaluate the relevance of each question of the FKSI-19, EORTC QLQ-C30, and EQ-5D (items rated as relevant vs non-relevant). Patients also responded to 2 open-ended questions regarding topics not covered by these measures and their perception of wearable technologies. Questions identified as meaningful required ≥66% “relevant” ratings. Descriptive statistics were collated, and open-ended questions were analyzed by 2 independent reviewers (CB, PB). Results: 116 patients were recruited from Brazil and the US. Most (69%) were male with a median age of 64 (32-88) years. 83% were diagnosed with advanced disease, and 75% received immunotherapy and/or targeted therapy as primary treatment. Few items across surveys were identified as meaningful including 8/19 FKSI-19 questions (lack of energy, fatigue, appetite, sleeping, worry, able to work, enjoyment and quality of life), 3/30 EORTC QLQ-C30 questions (tired, overall health and quality of life), and 0/5 EQ-5D questions. Patients suggested items pertaining to treatment side effects, emotional symptoms, physical function, social/family support, and financial distress should be included. Notably, 58% of patients were open to using wearable devices to assess HRQOL. Conclusions: Our multi-institutional international study confirms findings from our single-institution pilot data suggesting that HRQOL measures for RCC require substantial refinement. These data will inform development of a novel-RCC specific HRQOL tool in a joint effort between experts and patients.
PDF
