scholarly journals Prognostic Impact of Lymphnode Metastases in Patients with Metastatic Renal Cell Carcinoma

Kidney Cancer ◽  
2021 ◽  
pp. 1-8
Author(s):  
Hendrik Eggers ◽  
Marie Luise Tiemann ◽  
Inga Peters ◽  
Markus Antonius Kuczyk ◽  
Viktor Grünwald ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Impact ◽  
Solid Organ ◽  
Risk Of Death ◽  
Line Of Therapy ◽  
The Impact ◽  
Similar Risk

BACKGROUND: Lymphnode metastases (LMN) in metastatic renal cell carcinoma (mRCC) has been associated with an unfavourable prognosis. However, the prognostic impact of LNM in mRCC in context of other solid organ metastases and throughout subsequent therapeutic lines is not well-defined. OBJECTIVE: This retrospective single-center analysis was designed to elucidate the impact of LNM in the context of other solid organ metastases and throughout subsequent therapeutic lines. METHODS: mRCC patients (pts) at our center were analysed (observation period, 04/00-03/16). Primary endpoint was overall survival (OS) and the impact of line of therapy as a co-variate. Pts were grouped into: with LNM [LNM(+)], without LNM [LNN(–)]. Subgroup analyses of LNM(+) was performed including the subgroup LNM(+) and other solid organ metastases [LNM(+) other] and LNM(+) without other solid organ metastases [LMN(+) only]. RESULTS: 383/401 mRCC pts were eligible. 318 (83.2%), 230 (60.1%) and 154 (40.5%) pts received 1stL, 2ndL and 3rdL medical treatment, respectively. In the overall population OS was 40.1 months (95%CI: 32.7–47.4), with superior OS in LNM(–) compared to LNM(+) pts (log rank, HR 1.7, 95%-CI 1.3-2.2, p <  0.001). This effect was maintained across lines of therapies. LNM(+) only had a similar risk of death as LNM(–) pts (HR 1.2, 95%-CI 0.8–2.0, p = 0.4), while the risk of death was significantly increased for LNM(+) other compared to LNM(–) (HR 1.9, 95%-CI 1.5–2.6, p <  0.001). CONCLUSION: LNM(+) in mRCC is associated with a poor OS. However, impaired OS in LNM(+) might be associated with the presence of other solid organ metastases rather than with the existence of LNM alone. Further studies are warranted to support this hypothesis.

scholarly journals Prognostic value of DCE-CT-derived blood volume and flow compared to core biopsy microvessel density in patients with metastatic renal cell carcinoma

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Aska Drljevic-Nielsen ◽  
Finn Rasmussen ◽  
Patricia Switten Nielsen ◽  
Christina Stilling ◽  
Kennet Thorup ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Blood Volume ◽  
Metastatic Renal Cell Carcinoma ◽  
Microvessel Density ◽  
Renal Cell ◽  
Core Biopsy ◽  
Progression Free Survival ◽  
Prognostic Impact ◽  
Tumour Metastasis

Abstract Background Angiogenesis is prominent in metastatic renal cell carcinoma (mRCC). We compared two angiogenesis assessment methods: dynamic contrast-enhanced computed tomography (DCE-CT)-derived blood volume (BV) and blood flow (BF) and core biopsy microvessel density (MVD). Methods As planned in DaRenCa Study-1 study, DCE-CT and core biopsy were performed from the same tumour/metastasis at baseline. MVD was assessed by CD34 immunostaining in tumour (CD34-indexT) or tumour including necrosis (CD34-indexTN). BV and BF were assessed using the DCE-CT software. Overall survival (OS) and progression-free survival (PFS) were assessed by Kaplan-Meier analysis. Spearman coefficient (rho) tested the correlation between MVD and BV, BF, or CT density (HU). Results At baseline, 25 patients had analysable scans and tissue. BVdeconv, BVPatlak, and BFdeconv > median were associated with favourable OS (43.2 versus 14.6 months, p = 0.002; 31.6 versus 20.2 months, p = 0.015; and 31.6 versus 24.5 months, p = 0.019). CD34-indexT and CD34-indexTN did not correlate with age (p = 0.543), sex (p = 0.225), treatment (p = 0.848), International mRCC Database Consortium category (p = 0.152), synchronous versus metachronous metastatic disease (p = 0.378), or tumour volume (p = 0.848). CD34-indexT or CD34-indexTN > median was not associated with PFS (p = 0.441 and p = 0.854, respectively) or OS (p = 0.987 and p =0.528, respectively). CD34-indexT or CD34-indexTN was not correlated with BV, BF, or HU (rho 0.20–0.26). Conclusions Differently from MVD, DCE-CT-derived BV and BF had prognostic impact and may better reflect angiogenesis in mRCC. Trial registration NCT01274273

MP67-11 THE IMPACT OF MODIFIED INTERNATIONAL METASTATIC RENAL CELL CARCINOMA DATABASE CONSORTIUM MODEL USING A TWO-STEP STRATIFICATION PROCESS

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Suguru Shirotake ◽  
Hideyuki Kondo ◽  
Yota Yasumizu ◽  
Koshiro Nishimoto ◽  
Nobuyuki Tanaka ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
The Impact

scholarly journals MP25-05 THE IMPACT OF CYTOREDUCTIVE NEPHRECTOMY IN METASTATIC RENAL CELL CARCINOMA – A REAL-WORLD INVESTIGATION IN THE TKI ERA

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Florian Janisch ◽  
Constantin Fühner ◽  
Christian P. Meyer ◽  
Tobias Hillemacher ◽  
Thomas Klotzbücher ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Real World ◽  
Renal Cell ◽  
Cytoreductive Nephrectomy ◽  
The Impact

The Impact of PBRM1 Expression as a Prognostic and Predictive Marker in Metastatic Renal Cell Carcinoma

2015 ◽  
Vol 194 (4) ◽  
pp. 1112-1119 ◽  
Author(s):  
Ji-Yeon Kim ◽  
Se-Hoon Lee ◽  
Kyung Chul Moon ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Predictive Marker ◽  
The Impact

scholarly journals Prognostic impact of systemic therapy change in metastatic renal cell carcinoma treated with cytoreductive nephrectomy

2020 ◽  
Author(s):  
Hiroki Ishihara ◽  
Toshio Takagi ◽  
Tsunenori Kondo ◽  
Hironori Fukuda ◽  
Hidekazu Tachibana ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Systemic Therapy ◽  
Renal Cell ◽  
Immune Checkpoint Inhibitor ◽  
Prognostic Impact ◽  
Limited Data ◽  
Cytoreductive Nephrectomy ◽  
Histopathological Type

Abstract Objective Limited data are available regarding the effect of systemic therapy change in the post-cytokine era on survival of metastatic renal cell carcinoma (mRCC) patients undergoing cytoreductive nephrectomy (CN). Methods Overall, 161 patients with synchronously mRCC were retrospectively evaluated. The patients were classified into three groups based on the time of diagnosis: (i) early molecular-targeted therapy (mTT) (2008–2011), (ii) late mTT (2012–8/2016) and (iii) immune checkpoint inhibitor (ICI) eras (9/2016–2018). Overall survival (OS) after the diagnosis was compared among the eras. Results Of the 161 patients, 52 (32%), 75 (46%), and 34 patients (21%) were classified into the early mTT, late mTT and ICI eras, respectively. OS was significantly longer in the ICI and late mTT eras than that in the early mTT era (P = 0.0065 and P = 0.0010, respectively) but did not significantly differ between the ICI and late mTT eras (P = 0.389). In 112 patients undergoing CN and systemic therapy, OS was significantly longer in the ICI and late mTT eras than that in the early mTT era (P = 0.0432 and P = 0.0498, respectively) but did not significantly differ between the ICI and late mTT eras (P = 0.320). Multivariate analysis of OS in the 161 synchronous mRCC patients revealed that the era was an independent factor (P &lt; 0.0001), together with the histopathological type (P = 0.0130), CN status (P = 0.0010), International Metastatic Renal Cell Carcinoma Database Consortium risk (P = 0.0002) and liver metastasis status (P = 0.0124). Conclusion This retrospective analysis showed that systemic therapy change in the post-cytokine era improved OS of mRCC patients undergoing CN.

The impact of rhabdoid differentiation on prognosis in patients with grade 4 renal cell carcinoma.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 494-494
Author(s):  
Ben Yiming Zhang ◽  
John C. Cheville ◽  
Robert Houston Thompson ◽  
Stephen A. Boorjian ◽  
Christine M. Lohse ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Risk Of Death ◽  
Pathologic Features ◽  
Increased Risk ◽  
Grade 3 ◽  
Rhabdoid Differentiation ◽  
The Impact ◽  
Sarcomatoid Differentiation

494 Background: Renal cell carcinoma (RCC) with rhabdoid differentiation is thought to portend a poor prognosis, similar to RCC with sarcomatoid differentiation. Both rhabdoid and sarcomatoid differentiation are classified as grade 4 RCC based on the most recent International Society of Urological Pathology (ISUP) grading system. We sought to determine the prognostic value of rhabdoid differentiation in comparison to RCC with sarcomatoid differentiation, grade 4 RCC without rhabdoid or sarcomatoid differentiation, and grade 3 RCC. Methods: Using the Mayo Clinic Nephrectomy Registry, we identified 406 patients with ISUP grade 4 RCC and 1,758 patients with grade 3 RCC. A urologic pathologist reviewed all specimens to determine the presence of both rhabdoid and sarcomatoid differentiation. Associations of clinical and pathologic features with death from RCC were evaluated using Cox models. Results: Among the 406 grade 4 RCC tumors, 111 (27%) had rhabdoid differentiation and 189 (47%) had sarcomatoid differentiation, although only 28 (7%) demonstrated both rhabdoid and sarcomatoid differentiation. In multivariable analysis of grade 4 RCC tumors, the presence of rhabdoid differentiation was not associated with death from RCC (HR 0.95, p=0.75); in contrast, sarcomatoid differentiation was significantly associated with death from RCC (HR 1.63, p<0.001). Patients with RCC with rhabdoid differentiation were significantly more likely to die of RCC than patients with grade 3 RCC (HR 2.45, p<0.001) and grade 3 RCC with necrosis (HR 1.62; p<0.001). Conclusions: This study confirms that RCC with rhabdoid differentiation is appropriately classified as grade 4. However, unlike sarcomatoid differentiation, the presence of rhabdoid differentiation in grade 4 RCC is not associated with an increased risk of death from RCC. Therefore, rhabdoid and sarcomatoid differentiation should not be grouped together when assessing risk in a patient with grade 4 RCC.

Sign in / Sign up

Export Citation Format

Share Document