This study helps answer that question through meta-analysis - analyzing previous analyses to provide guidance when prior research was inconclusive or incomplete. Researchers in the Center for the Science of Health Care Delivery perform this type of work often, providing critical support to research and studies that then are implemented broadly and transform the practice for many health care providers across departments to improve access and satisfaction for patients.

"These types of projects take a lot of effort and collaboration," says Dr. Zaid.


Dr. Zaid performed the meta-analysis with guidance from M. Hassan Murad, M.D., a health services researcher in the Center for the Science of Health Care Delivery and a co-author. For their paper, they only chose "observational studies with a low to moderate risk of bias," the researchers wrote, but the potential still existed.

"Dr. Murad helped guide me through the steps of acquiring the data, finding the specific research papers, doing our analysis, and putting forward a meaningful conclusion," says Dr. Zaid. "Synthesizing a large amount of data, it's sometimes a little bit overwhelming, but he was critical in that regard. He's also just a great mentor and an endless wealth of knowledge."

Since the majority of the data analyzed in this study was published, immunotherapies and other drug therapies for kidney cancer have advanced considerably. The U.S. Food and Drug Administration approved the first drug for kidney cancer treatment in 1992, but there are more than 10 today, and most were approved in the past decade, according to the National Cancer Institute.

"Now that we have some better drugs for treating these patients, does our conclusion still hold true? We suspect that it will," says Dr. Leibovich. "In people who haven't had complete removal of the metastases, drug therapy seems to benefit. But in patients who have that surgery, drug therapy doesn't seem to make a difference."

With one of their next studies, the team is evaluating the interaction of surgery and drugs to determine if the combination increases survival even more.

Dr. Leibovich says the concern is that, because there are myriad drug treatments available, patients may not be referred to surgeons, or medical oncologists may not consider surgery as an option.

"Is that so bad if we have all these drugs? The answer is maybe yes, because the drugs, while they have improved survival, are not usually curative," says Dr. Leibovich. "If they work for only a finite period, and if surgery can lengthen the time before we need to enter that period, then we think that's potentially additive to overall survival."

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