Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Adjuvant interferon alpha treatment of non-metastatic renal cell carcinoma (RCC)-role of selection factors

RF Basting MD, D Händel MD, D Schmidt

Kreiskrankenhaus Alt Neuotting-Academic Hospital, Altoetting, Germany,

AIMS: The adjuvant immunotherapy of nonmetastatic RCC with interferon alpha is still conversely discussed. It was the aim of the presented study to find selection criteria for patients profiting from this treatment. We investigated T-stage, grading, ploidy and s-phase. METHODS: Survival data of 119 patients who underwent tumor-nephrectomy due to nonmetastatic RCC between 1987 and 1995 were documented. T-stage and grading were analyzed and for DANN - analysis ploidy and s-phase was measured by means of DANN -single cell cytophotometry. 33 patients received an adjuvant treatment with interferon alpha for one year in four ten day cycles 1.5 Mio daily. Statistical evaluation was performed by Kaplan-Meier-method with the logrank -test. RESULTS: T- stage and ploidy turned out to be excellent prognostic parameters with better survival in patients with T2 vs T3/4 and diploid vs aneuploid tumors. In the unselected patient group no advantage for an adjuvant interferon therapy could be seen. The results demonstrate T-stage and grading being inappropriate selection factors for the interferon therapy. However a marginal better survival rate was seen in patients with diploid vs aneuploid tumors after the adjuvant immunotherapy. The results of these analysis will be presented. CONCLUSIONS: The data show that an interferon treatment in nonmetastatic RCC might improve survival in patients with the prognostic better aneuploid tumors. However further investigations in randomized prospective studies are necessary to generally recommend this therapy in a selected group of patients.

KEY WORDS: Interferon alpha, adjuvant therapy, renal cell carcinoma, waterjet, l igasure, online-partial nephrectomy, nephron-sparing operation, jetcutting.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on immunotherapy.