Operative Therapy and Postoperative Adjuvant Therapy in Patients with Renal Caner_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Jin , LI Xiang , FU Guangqing , ZHANG Peng , LI Hong

Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Renal Cancer; Operative therapy; Postoperative adjuvant therapy

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

In this paper, systematic reviews, randomized controlled trials and other relevant studies on surgical and adjuvant therapy following operative therapy in renal cancer were identified by searching the Guidelines International Network, ACP Journal Club, the Cochrane Library （Issue 3, 2005 ） , MEDLINE, EMBASE and CBMdisc （ from 1996 to Sept. 2005）. In operative therapy, we found no study comparing operative therapy with no treatment or adjuvant therapy alone; A meta-analysis of cytoreductive nephrectomy in patients with metastatic renal cancer showed adjuvant therapy following nephrectomy was more effective than adjuvant therapy alone; a review comparing radical nephrectomy with nephron-sparing surgery in small-volume renal tumors found similar effectiveness between the two procedures. In the adjuvant therapy following nephrectomy, ten RCTs found adjuvant cytokine therapy （Interferon and Interleukin-2 ） and 5-FU not effective in the adjuvant setting, and could increase adverse reaction; Four RCTs found adjuvant vaccine therapy effective in the adjuvant setting with only a few side effects.

Citation： HUANG Jin ,LI Xiang,FU Guangqing,ZHANG Peng,LI Hong. Operative Therapy and Postoperative Adjuvant Therapy in Patients with Renal Caner. Chinese Journal of Evidence-Based Medicine, 2005, 05(11): 874-878. doi: Copy

1.	朱伟, 付杰新, 李建安, 陈伯川, 易钢. α-干扰素在肾癌根治术后的治疗作用[J]. 中华泌尿外科杂志, 2001; 22(6): 350～352.
2.	朱伟, 付杰新, 李建安, 陈伯川, 易钢. α-干扰素在肾癌根治术后的应用[J]. 临床泌尿外科杂志, 2001; 16(6): 261～352.
3.	徐万海, 王晓民, 孙理, 曾宪辉, 刘建光. 力尔凡联合α-干扰素和白细胞介素-2治疗肾癌的临床观察[J]. 中国肿瘤临床, 2003; 30(12): 865～867.
4.	Doehn C, Kausch I, Melz S, Behm A, Jocham D. Cytokine and vaccine therapy of kidney cancer[J]. Expert Review of Anticancer Therapy, 2004; 4(6): 1097-1111.
5.	Levels of Evidence and Grades of Recommendation[J]. Available from: URL: http://www.cebm.net/levels_of_evidence.asp.
6.	Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED. Cytoreductive nephrectomy in patients with metastatic renal cancer: A combined analysis[J]. Journal of Urology, 2004; 171(3): 1071-1076.
7.	Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, Caton JR Jr, Munshi N, Crawford ED. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic 60 renal-cell cancer[J]. New England Journal of Medicine, 2001; 345(23): 1655-1659.
8.	Mickisch GHJ, Garin A, Van Poppel H, De Prijck L, Sylvester R. Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: A randomised trial[J]. Lancet, 2001; 358(9286): 966-970.
9.	Manikandan R, Srinivasan V, Ranee A. Which Is the Real Gold Standard for Small-Volume Renal Tumors? Radical Nephrectomy versus Nephron-Sparing Surgery[J]. Journal of Endourology, 2004; 18(1): 39-44.
10.	Naito S, Kumazawa J, Sagiyama K, Hiratsuka Y, Omoto T, Iguchi A, Osada Y. Postoperative adjuvant therapy with IFN-α and the risk factors for recurrence in low stage renal cell carcinoma[J]. Journal of Japan Society for Cancer Therapy, 1996; 31(5): 342-348.
11.	Pizzocaro G, Piva L, Colavita M, Ferri S, Artusi R, Boracchi P, Parmiani G, Marubini E. Interferon adjuvant to radical nephrectomy in Robson stages Ⅱ and Ⅲ renal cell carcinoma: A multicentric randomized study[J]. Journal of Clinical Oncology, 2001; 19(2): 425-431.
12.	Messing EM, Manola J, Wilding G, Propert K, Fleischmann J, Crawford ED, Pontes JE, Hahn R, Trump D. Phase Ⅲ study of interferon alfa-NL as adjuvant treatment for resectable renal cell carcinoma: an Eastern Cooperative Oncology Group/Intergroup trial[J]. J Clin Oncol, 2003; 21(7): 1214-1222.
13.	Zhu W, Fu JX, Li JA, Chen BC, Yi G. α-interferon in the treatment of renal cell carcinoma after radical nephrectomy[J]. Chin J Urol, 2001; 22(6): 350-352.
14.	Zhu W, Fu JX, Li JA, Chen BC, Yi G. Postoperative usage of α-interferon in the treatment of renal cell carcinoma[J]. Journal of Clinical Urology, 2001; 22(6): 350-352.
15.	Clark JI, Atkins MB, Urba WJ, et al. Adjuvant high-dose bolus interleukin-2 for patients with high-risk renal cell carcinoma: a cytokine working group randomized trial[J]. J Clin Oncol, 2003; 21(16): 3133-3140.
16.	Naito S, Kumazawa J, Omoto T, Iguchi A, Sagiyama K, Osada Y, Hiratsuka Y. Postoperative UFT adjuvant and the risk factors for recurrence in renal cell carcinoma: A long-term follow-up study[J]. International Journal of Urology, 1997; 4(1): 8-12.
17.	Jayson GC, Middleton M, Lee SM, Ashcroft L, Thatcher N. A randomized phase Ⅱ trial of interleukin 2 and interleukin 2-interferon alpha in advanced renal cancer[J]. British Journal of Cancer, 1998; 78(3): 366-369.
18.	Figlin RA, Thompson JA, Bukowski RM, Vogelzang NJ, Novick AC, Lange P, Steinberg GD, Belldegrun AS. Multicenter, randomized, phase Ⅲ trial of CD8+ tumor-infiltrating lymphocytes in combination with recombinant interleukin-2 in metastatic renal cell carcinoma[J]. Journal of Clinical Oncology, 1999; 17(8): 2521-2529.
19.	Atzpodien J, Schmitt E, Gertenbach U, Fornara P, Heynemann H, Maskow A, Ecke M, Wltjen HH, Jentsch H, Wieland W, Wandert T, Reitz M. Adjuvant treatment with interleukin-2- and interferon-alpha2a-based chemoimmunotherapy in renal cell carcinoma post tumour nephrectomy: Results of a prospectively randomised Trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Group (DGCIN)[J]. British Journal of Cancer, 2005; 92(5): 843-846.
20.	Xu WH, Wang XM, Sun L, Zeng XH, Liu JG. Clinical study on combination of Lifein, α-interferon and Interleukin-2 in the treatment of renal cell carcinoma[J]. Chinese Oncology Clinic, 2003; 30(12): 865-867.
21.	Galligioni E, Quaia M, Merlo A, Carbone A, Spada A, Favaro D, Santarosa M, Sacco C, Talamini R, Francini M, Crivellari D, Di Donna D, Mazza G, Viggiano G, Galassi P, Panizzo R, Carmignani G, Fiaccavento G. Adjuvant immunotherapy treatment of renal carcinoma patients with autologous tumor cells and Bacillus Calmette-Guerin: Five-year results of a prospective randomized study[J]. Cancer, 1996; 77(12): 2560-2566.
22.	Jocham D, Richter A, Hoffmann L, Iwig K, Fahlenkamp D, Zakrzewski G, Schmitt E, Dannenberg T, Lehmacher W, Von Wietersheim J, Doehn C. Adjuvant autologous renal tumour cell vaccine and risk of tumour progression in patients with renal-cell carcinoma after radical nephrectomy: Phase Ⅲ, randomised controlled trial[J]. Lancet, 2004; 363(9409): 594-599.
23.	Doehn Ch, Richter A, Lehmacher W, Jocham D. Adjuvant autologous tumour cell-lysate vaccine versus no adjuvant treatment in patients with M0 renal cell carcinoma after radical nephrectomy: 3-year interim analysis of a German multicentre phase-Ⅲ trial[J]. Folia Biologica, 2003; 49(2): 69-73.
24.	Repmann R, Goldschmidt AJW, Richter A. Adjuvant therapy of renal cell carcinoma patients with an autologous tumor cell lysate vaccine: A 5-year follow-up analysis[J]. Anticancer Research, 2003; 23(2 A): 969-974.

1. 朱伟, 付杰新, 李建安, 陈伯川, 易钢. α-干扰素在肾癌根治术后的治疗作用[J]. 中华泌尿外科杂志, 2001; 22(6): 350～352.
2. 朱伟, 付杰新, 李建安, 陈伯川, 易钢. α-干扰素在肾癌根治术后的应用[J]. 临床泌尿外科杂志, 2001; 16(6): 261～352.
3. 徐万海, 王晓民, 孙理, 曾宪辉, 刘建光. 力尔凡联合α-干扰素和白细胞介素-2治疗肾癌的临床观察[J]. 中国肿瘤临床, 2003; 30(12): 865～867.
4. Doehn C, Kausch I, Melz S, Behm A, Jocham D. Cytokine and vaccine therapy of kidney cancer[J]. Expert Review of Anticancer Therapy, 2004; 4(6): 1097-1111.
5. Levels of Evidence and Grades of Recommendation[J]. Available from: URL: http://www.cebm.net/levels_of_evidence.asp.
6. Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED. Cytoreductive nephrectomy in patients with metastatic renal cancer: A combined analysis[J]. Journal of Urology, 2004; 171(3): 1071-1076.
7. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, Caton JR Jr, Munshi N, Crawford ED. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic 60 renal-cell cancer[J]. New England Journal of Medicine, 2001; 345(23): 1655-1659.
8. Mickisch GHJ, Garin A, Van Poppel H, De Prijck L, Sylvester R. Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: A randomised trial[J]. Lancet, 2001; 358(9286): 966-970.
9. Manikandan R, Srinivasan V, Ranee A. Which Is the Real Gold Standard for Small-Volume Renal Tumors? Radical Nephrectomy versus Nephron-Sparing Surgery[J]. Journal of Endourology, 2004; 18(1): 39-44.
10. Naito S, Kumazawa J, Sagiyama K, Hiratsuka Y, Omoto T, Iguchi A, Osada Y. Postoperative adjuvant therapy with IFN-α and the risk factors for recurrence in low stage renal cell carcinoma[J]. Journal of Japan Society for Cancer Therapy, 1996; 31(5): 342-348.
11. Pizzocaro G, Piva L, Colavita M, Ferri S, Artusi R, Boracchi P, Parmiani G, Marubini E. Interferon adjuvant to radical nephrectomy in Robson stages Ⅱ and Ⅲ renal cell carcinoma: A multicentric randomized study[J]. Journal of Clinical Oncology, 2001; 19(2): 425-431.
12. Messing EM, Manola J, Wilding G, Propert K, Fleischmann J, Crawford ED, Pontes JE, Hahn R, Trump D. Phase Ⅲ study of interferon alfa-NL as adjuvant treatment for resectable renal cell carcinoma: an Eastern Cooperative Oncology Group/Intergroup trial[J]. J Clin Oncol, 2003; 21(7): 1214-1222.
13. Zhu W, Fu JX, Li JA, Chen BC, Yi G. α-interferon in the treatment of renal cell carcinoma after radical nephrectomy[J]. Chin J Urol, 2001; 22(6): 350-352.
14. Zhu W, Fu JX, Li JA, Chen BC, Yi G. Postoperative usage of α-interferon in the treatment of renal cell carcinoma[J]. Journal of Clinical Urology, 2001; 22(6): 350-352.
15. Clark JI, Atkins MB, Urba WJ, et al. Adjuvant high-dose bolus interleukin-2 for patients with high-risk renal cell carcinoma: a cytokine working group randomized trial[J]. J Clin Oncol, 2003; 21(16): 3133-3140.
16. Naito S, Kumazawa J, Omoto T, Iguchi A, Sagiyama K, Osada Y, Hiratsuka Y. Postoperative UFT adjuvant and the risk factors for recurrence in renal cell carcinoma: A long-term follow-up study[J]. International Journal of Urology, 1997; 4(1): 8-12.
17. Jayson GC, Middleton M, Lee SM, Ashcroft L, Thatcher N. A randomized phase Ⅱ trial of interleukin 2 and interleukin 2-interferon alpha in advanced renal cancer[J]. British Journal of Cancer, 1998; 78(3): 366-369.
18. Figlin RA, Thompson JA, Bukowski RM, Vogelzang NJ, Novick AC, Lange P, Steinberg GD, Belldegrun AS. Multicenter, randomized, phase Ⅲ trial of CD8+ tumor-infiltrating lymphocytes in combination with recombinant interleukin-2 in metastatic renal cell carcinoma[J]. Journal of Clinical Oncology, 1999; 17(8): 2521-2529.
19. Atzpodien J, Schmitt E, Gertenbach U, Fornara P, Heynemann H, Maskow A, Ecke M, Wltjen HH, Jentsch H, Wieland W, Wandert T, Reitz M. Adjuvant treatment with interleukin-2- and interferon-alpha2a-based chemoimmunotherapy in renal cell carcinoma post tumour nephrectomy: Results of a prospectively randomised Trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Group (DGCIN)[J]. British Journal of Cancer, 2005; 92(5): 843-846.
20. Xu WH, Wang XM, Sun L, Zeng XH, Liu JG. Clinical study on combination of Lifein, α-interferon and Interleukin-2 in the treatment of renal cell carcinoma[J]. Chinese Oncology Clinic, 2003; 30(12): 865-867.
21. Galligioni E, Quaia M, Merlo A, Carbone A, Spada A, Favaro D, Santarosa M, Sacco C, Talamini R, Francini M, Crivellari D, Di Donna D, Mazza G, Viggiano G, Galassi P, Panizzo R, Carmignani G, Fiaccavento G. Adjuvant immunotherapy treatment of renal carcinoma patients with autologous tumor cells and Bacillus Calmette-Guerin: Five-year results of a prospective randomized study[J]. Cancer, 1996; 77(12): 2560-2566.
22. Jocham D, Richter A, Hoffmann L, Iwig K, Fahlenkamp D, Zakrzewski G, Schmitt E, Dannenberg T, Lehmacher W, Von Wietersheim J, Doehn C. Adjuvant autologous renal tumour cell vaccine and risk of tumour progression in patients with renal-cell carcinoma after radical nephrectomy: Phase Ⅲ, randomised controlled trial[J]. Lancet, 2004; 363(9409): 594-599.
23. Doehn Ch, Richter A, Lehmacher W, Jocham D. Adjuvant autologous tumour cell-lysate vaccine versus no adjuvant treatment in patients with M0 renal cell carcinoma after radical nephrectomy: 3-year interim analysis of a German multicentre phase-Ⅲ trial[J]. Folia Biologica, 2003; 49(2): 69-73.
24. Repmann R, Goldschmidt AJW, Richter A. Adjuvant therapy of renal cell carcinoma patients with an autologous tumor cell lysate vaccine: A 5-year follow-up analysis[J]. Anticancer Research, 2003; 23(2 A): 969-974.

Chinese Journal of Evidence-Based Medicine

Operative Therapy and Postoperative Adjuvant Therapy in Patients with Renal Caner

Abstract Full text Figures/Tables Video References Cited by

Format

Content