scholarly journals Prognostic factors for overall survival in patients with clear cell metastatic renal cell carcinoma

Medicine ◽  
2021 ◽  
Vol 100 (31) ◽  
pp. e26826
Author(s):  
Dongrul Shin ◽  
Chang Wook Jeong ◽  
Cheryn Song ◽  
Minyong Kang ◽  
Seong Il Seo ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell

scholarly journals Prognostic factors for overall survival with targeted therapy in Chinese patients with metastatic renal cell carcinoma

2014 ◽  
Vol 8 (11-12) ◽  
pp. 821 ◽  
Author(s):  
Juping Zhao ◽  
Xin Huang ◽  
Fukang Sun ◽  
Renyi Ma ◽  
Haofei Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Chinese Patients ◽  
Patient Specific ◽  
The Mean

Introduction: We wanted to identify the prognostic factors for overall survival (OS) in Chinese patients with metastatic renal cell carcinoma (mRCC) treated with first-line targeted therapy (sorafenib or sunitinib).Methods: We retrospectively reviewed clinical data from 119 mRCC patients administered sorafenib or sunitinib at the Ruijin Hospital since 2007. OS rates were calculated by the Kaplan-Meier method. Each variable was investigated univariately and then multivariately using a stepwise algorithm. A multivariate Cox regression model analyzed baseline variables for prognostic significance.Results: The mean patient age was 57 ± 12 years; 37 patients (31%) received sorafenib and 82 (69%) received sunitinib. The mean OS was 22.7 ± 15.6 months (range: 2.8–68.7). OS rates at year 1, 3 and 5 were 74%, 57%, and 36%, respectively. Univariate analysis identified significant negative prognostic factors (p < 0.05) as Eastern Cooperative Oncology Group (ECOG) performance status ≥2, symptoms, no prior nephrectomy, microscopic necrosis, ≥2 metastatic sites, presence of liver, bone, or pancreas metastasis, hemoglobin less than the lower limit of normal (female <115 g/L, male <130 g/L), and serum alkaline phosphatase greater than the upper limit of normal (126 IU/L) at baseline, as well as a relative dose intensity of targeting agents in the first month (1M-RDI) of <50%. Multivariate analysis of OS identified 4 independent predictors: no symptoms, no bone or pancreas metastasis, and 1M-RDI of targeting agents (≥50%).Conclusions: With targeted therapy, there is some change in the prognostic factors for mRCC and target drug therapies (1M-RDI ≥50%) play an important role in the prognosis of mRCC. Continued progress in the identification of patient-specific prognostic factors for mRCC will require further advances in the understanding of tumour biology.

Prognostic factors for metastatic renal cell carcinoma patients with removed metastases: A multicenter study of 559 patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15071-e15071
Author(s):  
Sei Naito ◽  
Hidefumi Kinoshita ◽  
Tsunenori Kondo ◽  
Nobuo Shinohara ◽  
Takashi Kasahara ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Median Overall Survival ◽  
Group Performance ◽  
Hazard Ratio ◽  
Incomplete Resection

e15071 Background: Metastasectomy considered to prolong survival in patients with metastatic renal cell carcinoma (mRCC). However, data on the indications for metastasectomy are limited. We aimed to examine the prognosis and the prognostic factors of mRCC patients who underwent metastasectomy. Methods: We sent questionnaires to Japanese hospitals and collected the data of patients who were diagnosed with mRCC between January 1988 and December 2009 and who had their metastatic lesions removed. We calculated the overall survival between metastasectomy and death or until the last follow-up. We also analyzed the relationship between survival and clinical features and identified adverse prognostic factors by multivariate analysis. Furthermore, we identified the group with a poor prognosis on the basis of the number of prognostic factors for which the patients were positive. These findings were internally validated using bootstrap procedures and the c-index. Results: We collected the data of 559 patients from 48 institutions. The median overall survival period was 80 months (95% CI, 69.7-90.6 months). We detected 5 adverse prognostic factors: incomplete resection by metastasectomy (hazard ratio, 1.75; p = 0.0169); brain metastasis (hazard ratio, 3.26; p = 0.0002); C-reactive protein levels of >1.0 mg/dl (hazard ratio, 2.84; p < 0.0001); Eastern Cooperative Oncology Group performance status of >1 (hazard ratio, 1.65; p = 0.0274); and the worst nuclear grade, i.e., the nuclei of tumor cells are larger than those of normal tubular cells (hazard ratio, 1.59; p = 0.0348). Patients positive for 3 or more of theseadverse prognostic factors had a worse prognosis (median overall survival, 24 months) than those positive for less than 3 factors (median overall survival, 105 months). The c-index for this model was 0.65 at 2 years. Conclusions: We identified 5 adverse prognostic factors for predicting the survival of patients who underwent metastasectomy.

Expression of tyrosine kinase AXL receptor in patients with metastatic renal cell carcinoma treated with sunitinib and its association with clinical and pathological outcomes.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 439-439
Author(s):  
Luis Eduardo Rosa Zucca ◽  
Flavio Mavignier Carcano ◽  
Cristovam Scapulatempo ◽  
Renato Oliveira ◽  
Mariana Andozia Morini ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Clinical Outcome ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Univariate Analysis ◽  
Poor Prognostic Factor

439 Background: Renal cell carcinoma (RCC) represents 2 to 3% of all cancers of the Western countries. Currently, sunitinib, an anti-receptor tyrosine kinase (RTK), particularly of PDGFR and VEGFR, is the first-line therapy for metastatic RCC (mRCC), with significant improvement in clinical outcome. However, there is a lack of predictive biomarkers of sunitinib response. Recently, we and others have suggested that the RTK AXL may modify the response to sunitinib. Objective: To study the expression of AXL in a series of mRCC patients treated with sunitinib and to correlate it with patient’s clinico-pathological features and therapeutic response. Methods: Sixty four mRCC patients (51 clear cell carcinomas and 13 non-clear cell carcinomas) were evaluated and AXL expression was assessed by immunohistochemistry in TMAs. Results: AXL positivity was observed in 47% of cases. The multivariate survival analysis showed that AXL expression was a poor prognostic factor in patients with mRCC (HR 2.007, 1.006 - 4.006, p=0.048). In addition to the positivity for AXL, other prognostic factors were absence of nephrectomy, more than one site of metastasis, and bone metastasis. Considering only the clear cell subtype, the univariate analysis showed that AXL expression was statistically associated with a poor prognosis, with a median overall survival of 13 months vs. 43 months in patients with negative AXL. In this subtype, along with the AXL positivity, other prognostic factors were absence of nephrectomy, KPS, more than one site of metastasis, and liver metastasis. Moreover, AXL expression was associated with shorter progression to sunitinib. Conclusions: AXL expression was correlated with worse clinical outcome and may be an important prognostic biomarker in sunitinib-treated metastatic renal cell carcinoma patients.

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