Survival Outcomes Post Nephrectomy for Non-Metastatic Renal Cell Carcinoma in Four Latin American Countries: A Systematic Review of Real-World Studies

OBJECTIVES: This systematic review aimed to describe survival outcomes (overall survival [OS] and recurrence-free survival [RFS]) post nephrectomy for non-metastatic renal cancer carcinoma (RCC) in real-world studies among patients aged ≥ 18 years in Argentina, Brazil, Colombia, and Mexico.

METHODS: Search strategies were conducted in Embase, Scielo, Lilacs, CDSR and Scopus from 2015-2023. Two reviewers independently screened studies, extracted data, with a third reviewer resolving any discrepancies.

RESULTS: A total of 12 studies were included, six studies were conducted in Brazil, three Mexico and three in Argentina. The analyzed period in the studies varied from 1985 to 2017. Clear cell RCC was the predominant histology, and radical nephrectomy was the most frequent treatment. The most frequently reported disease stage was stage I. All studies reported at least one survival outcome (OS and/or RFS). Most studies did not report stage-specific OS or RFS (n=8), few studies reported stage-specific OS (3) and RFS (1). The 5-year OS for stage I varied from 77.6%-93% (n=5), stage II from 65%-71.9% (n=3) and stage III from 38%-55% (n=3). Among the studies that reported RFS (n=6), one reported 3-year RFS for stage I (89.7%). The remaining studies reported overall RFS for stage I-II or stage I-III (n=5), however the studies had a high percentage of stage I (51.7%-93.0%). These studies reported 5-year RFS for stage I-II of 72%-83.5% (n=3) and 10-year RFS for stage I-III of 59.6-89.5% (n=2).

CONCLUSIONS: This systematic review synthesizes real-world estimates on OS and RFS in non-metastatic RCC patients in four Latin American countries. There is a lack of stage specific RFS data in the included studies. The findings highlight a substantially low 5-year OS in stage II and III, emphasizing the vulnerability to recurrence and the need for adjuvant treatment post nephrectomy.