Risk-Adapted Use of Adjuvant Systemic Therapy After Nephrectomy for Renal Cell Carcinoma: A Population-Based Study in the Post-approval Era
Only a minority of eligible RCC patients received AST after nephrectomy.
The study examined real‑world use of adjuvant systemic therapy (AST) after nephrectomy in patients with renal cell carcinoma (RCC) from 2018 to 2022 using the SEER database. Only 18% of eligible patients received AST, but the proportion increased from 13% in 2018 to 36% in 2022. AST use was strongly associated with adverse pathologic features—T4 stage (33% vs. 18%), grade 4 (28% vs. 15%), and N1‑N2 stage (36% vs. 17%). Patients with at least one high‑risk feature were more likely to receive AST (28% vs. 14%). A stepwise increase in AST use was observed with an increasing number of high‑risk features, suggesting a dose‑response relationship.
Adjuvant systemic therapy is recommended for high‑risk localized RCC to reduce recurrence, yet real‑world uptake remains suboptimal. Understanding temporal trends and risk‑adapted prescribing helps identify gaps in guideline implementation and informs efforts to optimize postoperative management.
Bizonyítékszint: Feltételezés / hírjelzés. Nincs önálló tudományos bizonyíték.
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