{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:12:36Z","timestamp":1792782756059,"version":"4.5.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Johann Wolfgang Goethe-Universit\u00e4t, Frankfurt am Main","id":[{"id":"https:\/\/ror.org\/04cvxnb49","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test for differences in overall survival (OS) according to cytoreductive nephrectomy (CN) in medullary metastatic renal cell carcinoma (med-mRCC) relative to most comparable clear cell metastatic RCC (cc-mRCC) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within the Surveillance, Epidemiology and End Results (SEER) database (2000\u20132021), we identified 62 patients with med-mRCC vs. 10,372 with cc-mRCC. Propensity score matching (PSM, ratio 1:3), Kaplan-Meier plots and multivariable Cox regression analyses addressed were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 10,434 patients, 62 (0.6%) harbored med-mRCC vs. 10,372 (99.4%) cc-mRCC. Med-mRCC patients were younger (27 vs. 63 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), more frequently African American (74 vs. 6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and more frequently harbored N1 stages (52 vs. 28%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). After 1:3 PSM for age, race\/ethnicity, T-stage and N-stage, 62 of 62 (100%) med-mRCC (median OS 4 months) and 186 of 10,372 (2%) cc-mRCC patients (median OS 10 months) remained for further analyses. In med-mRCC, median OS was 9 months with CN vs. 3 months without CN (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In cc-mRCC, median OS was 28 months with CN vs. 5 months without CN (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In med-mRCC, CN independently predicted better OS (Hazard\u2019s Ratio [HR] 0.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), as well as in cc-mRCC (HR 0.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Med-mRCC patients exhibit a drastically different phenotype relative to their cc-mRCC counterparts. Despite this difference, med-mRCC exposed to CN harbor a similar relative protective survival effect compared to their cc-mRCC counterparts with most comparable age, race\/ethnicity and tumor characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06587-8","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:38:23Z","timestamp":1789807103000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of cytoreductive nephrectomy in metastatic medullary renal cell carcinoma: controlled analysis"],"prefix":"10.1007","volume":"44","author":[{"given":"Quynh Chi","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Marmiroli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Longoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Falkenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogero","family":"Catanzaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Nicolazzini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Polverino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan A.","family":"Goyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Saad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Schiavina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Fabio","family":"Carmignani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Briganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Longo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Graefen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Palumbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Siech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severine","family":"Banek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Traumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix K.-H.","family":"Chun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre I.","family":"Karakiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"issue":"5","key":"6587_CR1","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/j.hoc.2023.04.019","volume":"37","author":"P Msaouel","year":"2023","unstructured":"Msaouel P, Genovese G, Tannir NM (2023) Renal cell carcinoma of variant histology: biology and therapies. 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