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International Journal of Clinical Oncology

, Volume 24, Issue 6, pp 694–697 | Cite as

Adjuvant therapy in renal cell carcinoma: the perspective of urologists

  • Annabel SpekEmail author
  • B. Szabados
  • J. Casuscelli
  • C. Stief
  • M. Staehler
Original Article

Abstract

Background

Until recently, there was no approved adjuvant therapy (AT) for renal cell carcinoma (RCC) unless sunitinib was approved in the US. We evaluated clinical opinion and estimated use regarding different treatment options and patient selection of AT in RCC patients based on current scientific data and individual experience in Germany.

Methods

We conducted an anonymous survey during a national urology conference in 01/2017. Answers of 157 urologists treating RCC patients could be included. Questions were related to practice setting, treatment of RCC, follow-up strategy, physicians’ personal opinion and individually different important parameters regarding S-TRAC and ASSURE-trial.

Results

82% were office based. 67% were located in larger cities. 83% reported that nephron-sparing surgery (NSS) was performed in tumors with diameter < 4 cm. Follow-up was done mainly in concordance with guideline recommendations. 68% treated an average of 2.9 patients/year with systemic therapy. Therapy was predominantly advocated using sunitinib (94%). Urologists were informed about S-TRAC and ASSURE-trial. For 47%, reported hazard ratio is the most important parameter to understand trial results followed by overall survival (OS) in 46%, disease-free survival in 38%, and results of other trials in 34%. The most convincing parameter to decide on AT is OS (69%). 62% placed their confidence in ASSURE over STRAC-trial. 44% would use AT for 12 months. Nodal involvement was the most common denominator for use of AT. 82% favor sunitinib as AT.

Conclusions

A minority of urologists would use AT and are more confident in ASSURE-trial. Reluctance of prescribing AT mainly is based on lack of OS data and conflicting trial results.

Keywords

Renal cell carcinoma High-risk carcinoma Adjuvant therapy Statistical data interpretation Targeted therapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This manuscript does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of UrologyLudwig Maximilian UniversityMunichGermany

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