Nephrectomy Followed by Interferon Alfa-2b Compared With Interferon Alfa-2b Alone for Metastatic Renal Cell Cancer

Abstract

Background The value of nephrectomy in meta- static renal-cell cancer has long been debated. Several nonrandomized studies suggest a higher rate of re- sponse to systemic therapy and longer survival in pa- tients who have undergone nephrectomy. Methods We randomly assigned patients with met- astatic renal-cell cancer who were acceptable candi- dates for nephrectomy to undergo radical nephrecto- my followed by therapy with interferon alfa-2b or to receive interferon alfa-2b therapy alone. The primary end point was survival, and the secondary end point was a response of the tumor to treatment. Results The median survival of 120 eligible patients assigned to surgery followed by interferon was 11.1 months, and among the 121 eligible patients assigned to interferon alone it was 8.1 months (P=0.05). The dif- ference in median survival between the two groups was independent of performance status, metastatic site, and the presence or absence of a measurable metastatic lesion. Conclusions Nephrectomy followed by interferon therapy results in longer survival among patients with metastatic renal-cell cancer than does interferon ther- apy alone. (N Engl J Med 2001;345:1655-9.)