Testing the external validity of the EORTC randomized trial 30904 comparing overall survival after radical nephrectomy vs nephron‐sparing surgery in contemporary North American patients with renal cell cancer
EORTC 30904 reported that for solitary renal mass <=5cm, radical nephrectomy (RN) is associated with higher overall survival compared with nephron sparing surgery (NSS). This trial remains the only available level one evidence on this subject. To test external validity of the trial, patients who met clinical and pathological inclusion criteria of EORTC 30904 within the National Cancer Database (NCDB) were identified. We found that median age (60years in NCDB vs. 62years in trial) and median clinical tumour size (30mm in both) were similar between the cohorts. These two variables are most important determinants of mortality and stage of cancer, respectively, implying that the trial was able to recruit patients virtually representative of those seen in "real-world" practice. Moreover, in NCDB, more patients had clear-cell histology (81.9% vs. 62.9% in trial) and high-grade disease (21.1% vs. 11.2% in trial), implying more aggressive tumors compared to the trial. Arguably, these patients are better served with RN which has a higher probability of completely eradicating the tumor, making the results of the trial even more relevant to practice. Our results indicate that EORTC 30904 cohort was not significantly different from the NCDB cohort in a manner that could influence reported trial outcomes. This article is protected by copyright. All rights reserved.
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 November 2018.
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Altmetric has tracked 34,411,289 research outputs across all sources so far. Compared to these this one has done well and is in the 82nd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
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