Age is a powerful predictor of survival in pT2N0M0 clear cell renal cell cancer patients: A SEER-based study

Abstract Background: To elucidate whether age is a prognostic factor in clear cell renal cell cancer (ccRCC) with stage II (pT2N0M0,the American Joint Committee on Cancer 6 th or 7 th staging system) , we analyzed data from the SEER (Surveillance, Epidemiology and End Results) database to evaluate the impact of age on clinicopathological features and survival in pT2N0M0 ccRCC patients. Methods: A total of 2806 patients with stage II (pT2N0M0) were collected. Patients were categorized into three groups according to age at diagnosis as follows: young age (< 40 years, n = 129), middle-age (40-69 years, n = 2,075), and old age (≥ 70 years, n = 602) groups. Clinicopathological variables and survival rates were compared between the three groups. Results: 5-year overall survival (OS) rates were 93.0%, 83.9%, 69.3% respectively and 10-year OS rates were 87.6%, 74.5%, 47.0% respectively in the young, middle, and old age groups (P<0.001). 5-year cancer-specific survival (CSS) rates were 94.6%, 88.4%, 84.4% respectively and 10-year CSS rates were 90.7%, 82.1%, 74.6% respectively in the young, middle, and old age groups (P<0.001). Age at diagnosis was the only predictor for both overall survival and cancer-specific survival in multivariate analysis (each P<0.001). Age together with marital status, tumor size and grade were independent prognostic factors for CSS in multivariate analysis (P<0.001,P=0.017, P=0.001, P=0.02 respectively). Conclusions: Age at diagnosis is a powerful predictor for survival in pT2N0M0 clear cell renal cell cancer patients. Compared to their young counterparts, elder patients have a significantly worse outcome with regard to overall survival and cancer-specific survival.

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Deciphering Immune-Associated Genes to Predict Survival in Clear Cell Renal Cell Cancer

BioMed Research International ◽

10.1155/2019/2506843 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Daixing Hu ◽

Mi Zhou ◽

Xin Zhu

Keyword(s):

Overall Survival ◽

Renal Cell Cancer ◽

Renal Cell ◽

Clinical Characteristics ◽

Clear Cell ◽

Expression Profiles ◽

Cell Cancer ◽

Functional Enrichment ◽

Predictive Values ◽

Immune Score

Background. To elucidate the correlations between tumor microenvironment and clinical characteristics as well as prognosis in clear cell renal cell cancer (ccRCC) and investigate the immune-associated genes by a comprehensive analysis of The Cancer Genome Atlas (TCGA) database. Methods. We collected mRNA expression profiles of 537 ccRCC samples from the TCGA database. Immune scores and stromal scores were calculated by applying the ESTIMATE algorithm. We evaluated the correlation between immune/stromal scores and clinical characteristics as well as prognosis. The differentially expressed genes (DEGs) were screened between high immune/stromal score and low immune/stromal score groups by the cutoff of |log (fold change)| > 1, P value <0.05 by using package “limma” in R. Functional enrichment analysis was performed by DAVID, and the protein-protein interaction network of intersected DEGs between stromal score and immune score groups was conducted using the STRING database. The Kaplan–Meier method was used to explore DEGs with predictive values in overall survival, and the prognostic DEGs were further validated in a Gene Expression Omnibus (GEO) dataset GSE29609. Results. A higher immune score was associated with T3/4 (vs. T1/2, P<0.001), N1 (vs. N0, P=0.05), M1 (vs. M0, P=0.004), G3/4 (vs. G1/2, P<0.001), advanced AJCC stage (P<0.001), and shorter overall survival (P=0.04). Intersected DEGs between immune and stromal score groups were 48 upregulated and 47 downregulated genes, with 43 DEGs associated with overall survival in ccRCC. After validation by a cohort of 39 ccRCC cases with detailed follow-up information from GSE29609, six immune-associated DEGs including CASP5, HSD11B1, VSIG4, HMGCS2, HSD11B2, and OGDHL were demonstrated to be predictive of prognosis in ccRCC. Conclusions. Our study elucidated tight associations between immune score and clinical characteristics as well as prognosis in ccRCC. Moreover, six DEGs were explored and validated to exert predictive values in overall survival of ccRCC.

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Toxicities of axitinib, sunitinib and temsirolimus: implications for progression-free and overall survival in metastatic renal cell cancer

Future Oncology ◽

10.2217/fon-2020-0900 ◽

2020 ◽

Author(s):

Annemarie Uhlig ◽

Johannes Uhlig ◽

Lutz Trojan ◽

Michael Woike ◽

Marianne Leitsmann ◽

...

Keyword(s):

Overall Survival ◽

Cancer Patients ◽

Skin Reaction ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Progression Free Survival ◽

Cox Models ◽

Metastatic Renal Cell Cancer ◽

Hand Foot Skin Reaction

The aim of this study was to evaluate the association between axitinib, sunitinib and temsirolimus toxicities and patient survival in metastatic renal cell cancer patients. Overall survival (OS) and progression-free survival (PFS) of metastatic renal cell cancer patients from the prospective multicenter STAR-TOR study were assessed using multivariable Cox models. A total of 1195 patients were included (n = 149 axitinib; n = 546 sunitinib; n = 500 temsirolimus). The following toxicities significantly predicted outcomes: hand–foot skin reaction (hazard ratio [HR] = 0.29) for PFS with axitinib; stomatitis (HR = 0.62) and pneumonitis (HR = 0.23) for PFS with temsirolimus; stomatitis (HR = 0.52) and thrombocytopenia (HR = 0.6) for OS with temsirolimus; fatigue (HR = 0.71) for PFS with sunitinib; hand–foot skin reaction (HR = 0.56) and fatigue (HR = 0.58) for OS with sunitinib. In conclusion, in metastatic renal cell cancer, axitinib, sunitinib and temsirolimus demonstrate specific toxicities that are protective OS/PFS predictors.

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C07 Polymorphisms of RAGE and glyoxalase I genes in patients with clear cell renal cell cancer

European Urology Supplements ◽

10.1016/s1569-9056(13)61855-2 ◽

2013 ◽

Vol 12 (4) ◽

pp. e1115, C07

Author(s):

M. Chocholatý ◽

K. Havlová ◽

M. Schmidt ◽

M. Kalousová ◽

M. Jáchymová ◽

...

Keyword(s):

Renal Cell Cancer ◽

Renal Cell ◽

Clear Cell ◽

Cell Cancer ◽

Glyoxalase I

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NAXIVA: A phase II neoadjuvant study of axitinib for reducing extent of venous tumor thrombus in clear cell renal cell cancer (RCC) with venous invasion.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.275 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 275-275

Author(s):

Grant D. Stewart ◽

Sarah J. Welsh ◽

Stephan Ursprung ◽

Ferdia Gallagher ◽

Iosif Mendichovszky ◽

...

Keyword(s):

Renal Cell Cancer ◽

Surgical Approach ◽

Renal Cell ◽

Tumor Thrombus ◽

Response Rate ◽

Clear Cell ◽

Cell Cancer ◽

Surgical Morbidity ◽

Venous Tumor Thrombus ◽

Extent Of Surgery

275 Background: Venous tumor thrombus (VTT) extension occurs in 4-15% cases of renal cell cancer (RCC). The Mayo classification distinguishes 4 levels of VTT extension between the renal vein and supradiaphragmatic inferior vena cava (IVC). Although surgery is performed with curative intent, mortality is high (5-15%) with complications increasing with the level of the VTT. 5-year survival rates are poor; ~40-65% in non-metastatic RCC. It is hypothesised that neoadjuvant targeted therapy could downstage the VTT reducing the extent of surgery, leading to reduced surgical morbidity and mortality, and increased survival. However, level I or II evidence is lacking. NAXIVA provides the first level II evidence in this patient group, assessing the response of VTT to axitinib. Extensive translational sampling will provide in depth interrogation of VTT (using genomics, proteomics, immunophenotyping and metabolomics) to examine the role of the tumor microenvironment of VTT and response to axitinib. Methods: NAXIVA was a single arm, single agent, multi-center phase 2 feasibility study of axitinib in patients with both metastatic and non-metastatic clear cell RCC prior to nephrectomy and thrombectomy. A Simon two stage minimax design was adopted and the trial designed for adequate power to distinguish a <5% from a >25% improvement in the Mayo VTT level. 21 patients were recruited over a 24 month period between 15/Dec/2017 and 06/Jan/2020 at 5 sites across the UK. Patients were treated with 8 weeks of axitinib (starting dose 5mg bd, increasing to 10mg bd as tolerated) prior to planned surgery. The primary endpoint was the percentage of evaluable patients with an improvement in VTT according to the Mayo classification (assessed using MRI abdomen scans at screening and week 9, prior to surgery. Secondary endpoints were percentage change in surgical approach, percentage change in VTT height, response rate (by RECIST) and evaluation of surgical morbidity assessed by Clavien-Dindo classification. Results: The percentage of evaluable patients with an improvement in VTT according to the Mayo classification was 26.58% [80% CI: 15.76%, 39.74%] (6 of 21 evaluable patients). 35.29% (6 of 17 patients who progressed to surgery) had a change in surgical approach to a less invasive option. There was a median percentage reduction in VTT height of 21.49% (SD=27.60%). The response rate (by RECIST) in the evaluable population was 61.90% SD, 14.29% PR, 9.52% PD. In terms of surgical morbidity 11.76% (2 of 17 patients who progressed to surgery) experienced a Clavien-Dindo 3 or greater complication (0 CD3, 1 CD4, 1 CD5). Conclusions: NAXIVA provides unique prospective data on the feasibility of neoadjuvant axitinib administration to down stage IVC VTT and reduce the extent of surgery. Work is ongoing to establish predictors of response. Clinical trial information: NCT03494816 .

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A Four-Gene Promoter Methylation Marker Panel Consisting of GREM1, NEURL, LAD1, and NEFH Predicts Survival of Clear Cell Renal Cell Cancer Patients

Clinical Cancer Research ◽

10.1158/1078-0432.ccr-16-1236 ◽

2016 ◽

Vol 23 (8) ◽

pp. 2006-2018 ◽

Cited By ~ 25

Author(s):

Iris J.H. van Vlodrop ◽

Sophie C. Joosten ◽

Tim De Meyer ◽

Kim M. Smits ◽

Leander Van Neste ◽

...

Keyword(s):

Cancer Patients ◽

Renal Cell Cancer ◽

Promoter Methylation ◽

Renal Cell ◽

Clear Cell ◽

Cell Cancer ◽

Gene Promoter ◽

Marker Panel ◽

Methylation Marker

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Nephrectomy Followed by Interferon Alfa-2b Compared With Interferon Alfa-2b Alone for Metastatic Renal Cell Cancer

50 Studies Every Urologist Should Know ◽

10.1093/med/9780190655341.003.0020 ◽

2021 ◽

pp. 113-118

Author(s):

Christopher Weight

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell Cancer ◽

Renal Cell ◽

Performance Status ◽

Cell Cancer ◽

Interferon Alfa ◽

Cytoreductive Nephrectomy

This chapter summarizes the findings of a landmark trial of cytoreductive nephrectomy in patients with metastatic renal cell carcinoma performed in the interferon era. All enrolled patients had a good performance status. It found overall survival extended by about 3 months in the cytoreductive-nephrectomy-plus-interferon arm versus the interferon-only arm.

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