PMID- 31227307 OWN - NLM STAT- MEDLINE DCOM- 20210104 LR - 20210104 IS - 1873-7560 (Electronic) IS - 0302-2838 (Linking) VI - 76 IP - 4 DP - 2019 Oct TI - Surgical Safety of Cytoreductive Nephrectomy Following Sunitinib: Results from the Multicentre, Randomised Controlled Trial of Immediate Versus Deferred Nephrectomy (SURTIME). PG - 437-440 LID - S0302-2838(19)30455-5 [pii] LID - 10.1016/j.eururo.2019.06.006 [doi] AB - The European Organisation for Research and Treatment of Cancer SURTIME trial explored timing of sunitinib, a tyrosine kinase inhibitor (TKI), and cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma. Previous retrospective studies suggest increased surgery-related adverse events (AEs) after presurgical TKI. We report surgical safety from a randomised comparison of CN before or after sunitinib. In-hospital mortality, 30-d readmission rate, and intraoperative and 30-d postoperative AEs according to Common Terminology Criteria for Adverse Events version 4 and Clavien-Dindo (CD) were analysed. Patients were randomised 1:1 to immediate CN followed by sunitinib versus sunitinib followed by deferred CN 24h after the last dose of sunitinib. None of the tumours in the deferred arm became unresectable, and only two patients had a sunitinib-related delay of CN of >2wk. AEs related to surgery (all grades) in the immediate and deferred arms occurred in 52% and 53% after CN, respectively, although the number of intraoperative surgery-related AEs was higher in the immediate arm. Postoperative AEs (CD >/=3), 30-d readmission, and in-hospital mortality rates were 6.5%, 13%, and 4.3% in the immediate arm and 2.5%, 7.5%, and 2.5% in the deferred arm, respectively. There were no differences in surgery time, blood loss, and hospital stay. PATIENT SUMMARY: Patients with metastatic kidney cancer do not have more surgical complications irrespective of whether they are treated with systemic therapy before or after surgery. CI - Copyright (c) 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved. FAU - De Bruijn, Roderick Emile AU - De Bruijn RE AD - The Netherlands Cancer Institute, Amsterdam, The Netherlands. FAU - Mulders, Peter AU - Mulders P AD - Department of Urology, Radboud University Hospital, Nijmegen, The Netherlands. FAU - Jewett, Michael A AU - Jewett MA AD - Department of Urology, Princess Margaret Hospital, Toronto, Ontario, Canada. FAU - Wagstaff, John AU - Wagstaff J AD - Department of Oncology, Cardiff Hospital, Wales, UK. FAU - Van Thienen, Johan V AU - Van Thienen JV AD - The Netherlands Cancer Institute, Amsterdam, The Netherlands. FAU - Blank, Christian U AU - Blank CU AD - The Netherlands Cancer Institute, Amsterdam, The Netherlands. FAU - Van Velthoven, Roland AU - Van Velthoven R AD - Department of Urology, Institut Jules Bordet, Brussels, Belgium. FAU - Wood, Lori AU - Wood L AD - Division of Medical Oncology, QEII Health Sciences Center, Halifax, Nova Scotia, Canada. FAU - van Melick, Harm E AU - van Melick HE AD - Department of Urology, Saint Antonius Hospital, Nieuwegein, The Netherlands. FAU - Aarts, Maureen J AU - Aarts MJ AD - Department of Oncology, Maastricht University Medical Center, Maastricht, The Netherlands. FAU - Lattouf, Jean B AU - Lattouf JB AD - Department of Surgery Urology, University of Montreal Hospital Center, Quebec, Ontario, Canada. FAU - Powles, Thomas AU - Powles T AD - Department of Oncology, The Royal Free Hospital and Queen Mary University, London, UK. FAU - De Jong, Igle J AU - De Jong IJ AD - Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. FAU - Rottey, Sylvie AU - Rottey S AD - Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium. FAU - Tombal, Betrand AU - Tombal B AD - Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium. FAU - Marreaud, Sandrine AU - Marreaud S AD - Department of Statistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium. FAU - Collette, Sandra AU - Collette S AD - Department of Statistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium. FAU - Collette, Laurence AU - Collette L AD - Department of Statistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium. FAU - Haanen, John B AU - Haanen JB AD - The Netherlands Cancer Institute, Amsterdam, The Netherlands. FAU - Bex, Axel AU - Bex A AD - The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Urology, The Royal Free Hospital and University College London, London, UK. Electronic address: a.bex@ucl.ac.uk. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20190618 PL - Switzerland TA - Eur Urol JT - European urology JID - 7512719 RN - 0 (Antineoplastic Agents) RN - V99T50803M (Sunitinib) SB - IM CIN - Eur Urol. 2019 Oct;76(4):441-442. PMID: 31327639 CIN - Ann Transl Med. 2019 Dec;7(Suppl 8):S347. PMID: 32016065 MH - Antineoplastic Agents/*therapeutic use MH - Carcinoma, Renal Cell/*drug therapy/secondary/*surgery MH - Combined Modality Therapy MH - *Cytoreduction Surgical Procedures/adverse effects MH - Humans MH - Kidney Neoplasms/*drug therapy/pathology/*surgery MH - Nephrectomy/adverse effects/*methods MH - Sunitinib/*therapeutic use MH - Treatment Outcome OTO - NOTNLM OT - Cytoreductive nephrectomy OT - Renal cell carcinoma OT - Surgical safety EDAT- 2019/06/23 06:00 MHDA- 2021/01/05 06:00 CRDT- 2019/06/23 06:00 PHST- 2019/03/07 00:00 [received] PHST- 2019/06/10 00:00 [accepted] PHST- 2019/06/23 06:00 [pubmed] PHST- 2021/01/05 06:00 [medline] PHST- 2019/06/23 06:00 [entrez] AID - S0302-2838(19)30455-5 [pii] AID - 10.1016/j.eururo.2019.06.006 [doi] PST - ppublish SO - Eur Urol. 2019 Oct;76(4):437-440. doi: 10.1016/j.eururo.2019.06.006. Epub 2019 Jun 18.