scholarly journals Safety of Prolonged Wait Time for Nephrectomy for Clinically Localized Renal Cell Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Nienie Qi ◽  
Fangzheng Zhao ◽  
Xiaoxiao Liu ◽  
Wei Wei ◽  
Junqi Wang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Wait Time ◽  
Cancer Specific Survival ◽  
Pathological Subtype ◽  
Localized Renal Cell Carcinoma ◽  
Surgical Wait Time

BackgroundThere is usually a surgical wait time before nephrectomy for patients with clinically localized renal cell carcinoma, and many factors can influence this preoperative wait time. A relatively prolonged wait time may cause tumor progression. Therefore, we assessed the effect of preoperative wait time on the prognosis of patients with clinically localized renal cell carcinoma.MethodsThe outcomes of 561 patients with clinically localized renal cell carcinoma who underwent nephrectomy between July 2011 and March 2017 were retrospectively evaluated. According to the wait time before surgery, we divided the patients into three groups: short-wait group (≤ 30 days), intermediate-wait group (> 30 and ≤ 90 days), and long-wait group (>90 days). The clinicopathological characteristics were evaluated, and the survival rates of the three groups were compared.ResultsThis study included 370 male (66%) and 191(34%) female patients, with a median age of 64 years. There were 520 patients with stage T1 and 41 patients with stage T2 tumors. The median interval between diagnosis and surgery was 21 days. There were no significant differences in age, sex, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index, tumor size, surgical approach, surgical procedure, pathological subtype, tumor stage, tumor grade, and residual tumor among the three groups. Overall survival(OS) and cancer-specific survival (CSS) were comparable; the 5-year OS of the short-, intermediate-, and long-wait time groups were 84.2%, 82.0%, and 89.8%, respectively (P=0.732). The 5-year CSS rates of the short-, intermediate-, and long-wait time groups were 87.1%, 88.9%, and 90.4%, respectively (P=0.896). Multivariate analysis revealed that wait time was not an independent prognostic factor for OS or CSS.ConclusionProlonged surgical wait time (> 90 days) does not influence survival in patients with clinically localized renal cell carcinoma.

scholarly journals Impact of Age on the Cancer-Specific Survival of Patients with Localized Renal Cell Carcinoma: Martingale Residual and Competing Risks Analysis

PLoS ONE ◽  
2012 ◽  
Vol 7 (10) ◽  
pp. e48489 ◽  
Author(s):  
Muyan Cai ◽  
Jinhuan Wei ◽  
Zhiling Zhang ◽  
Hongwei Zhao ◽  
Yunqiao Qiu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Competing Risks ◽  
Renal Cell ◽  
Cancer Specific Survival ◽  
Martingale Residual ◽  
Competing Risks Analysis ◽  
Localized Renal Cell Carcinoma

Application of TNM, 2002 version, in localized renal cell carcinoma: is it able to predict different cancer-specific survival probability?

Urology ◽  
2004 ◽  
Vol 63 (6) ◽  
pp. 1050-1054 ◽  
Author(s):  
Vincenzo Ficarra ◽  
Giacomo Novara ◽  
Antonio Galfano ◽  
Giovanni Novella ◽  
Dionisio Schiavone ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Survival Probability ◽  
Renal Cell ◽  
Cancer Specific Survival ◽  
Localized Renal Cell Carcinoma

scholarly journals Racial and Ethnic Disparities in Preoperative Surgical Wait Time and Renal Cell Carcinoma Tumor Characteristics

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1183
Author(s):  
Eduardo Quinonez-Zanabria ◽  
Celina I. Valencia ◽  
Waheed Asif ◽  
Jiping Zeng ◽  
Ava C. Wong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Early Stage ◽  
Insurance Coverage ◽  
Wait Time ◽  
Special Focus ◽  
Tumor Characteristics ◽  
Public Insurance ◽  
Surgical Wait Time

Racial/ethnic minority groups have a disproportionate burden of kidney cancer. The objective of this study was to assess if race/ethnicity was associated with a longer surgical wait time (SWT) and upstaging in the pre-COVID-19 pandemic time with a special focus on Hispanic Americans (HAs) and American Indian/Alaska Natives (AIs/ANs). Medical records of renal cell carcinoma (RCC) patients who underwent nephrectomy between 2010 and 2020 were retrospectively reviewed (n = 489). Patients with a prior cancer diagnosis were excluded. SWT was defined as the date of diagnostic imaging examination to date of nephrectomy. Out of a total of 363 patients included, 34.2% were HAs and 8.3% were AIs/ANs. While 49.2% of HA patients experienced a longer SWT (≥90 days), 36.1% of Non-Hispanic White (NHW) patients experienced a longer SWT. Longer SWT had no statistically significant impact on tumor characteristics. Patients with public insurance coverage had increased odds of longer SWT (OR 2.89, 95% CI: 1.53–5.45). Public insurance coverage represented 66.1% HA and 70.0% AIs/ANs compared to 56.7% in NHWs. Compared to NHWs, HAs had higher odds for longer SWT in patients with early-stage RCC (OR, 2.38; 95% CI: 1.25–4.53). HAs (OR 2.24, 95% CI: 1.07–4.66) and AIs/ANs (OR 3.79, 95% CI: 1.32–10.88) had greater odds of upstaging compared to NHWs. While a delay in surgical care for early-stage RCC is safe in a general population, it may negatively impact high-risk populations, such as HAs who have a prolonged SWT or choose active surveillance.

YOUNG AGE IS AN INDEPENDENT FAVORABLE PROGNOSTIC FACTOR FOR CANCER-SPECIFIC SURVIVAL IN LOCALIZED RENAL CELL CARCINOMA PATIENTS

2009 ◽  
Vol 181 (4S) ◽  
pp. 351-351
Author(s):  
Yoshinobu Komai ◽  
Yasuhisa Fujii ◽  
Manabu Tatokoro ◽  
Yasumasa Iimura ◽  
Kazutaka Saito ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Young Age ◽  
Cancer Specific Survival ◽  
Favorable Prognostic Factor ◽  
Localized Renal Cell Carcinoma

The effectiveness of systemic therapies after surgery for metastatic renal cell carcinoma to the spine: a propensity analysis controlling for sarcopenia, frailty, and nutrition

2021 ◽  
pp. 1-10
Author(s):  
Elie Massaad ◽  
Philip J. Saylor ◽  
Muhamed Hadzipasic ◽  
Ali Kiapour ◽  
Kevin Oh ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Spine Surgery ◽  
Treatment Effect ◽  
Renal Cell ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Spinal Metastases ◽  
Metastatic Rcc ◽  
Systemic Therapies

OBJECTIVE The effectiveness of starting systemic therapies after surgery for spinal metastases from renal cell carcinoma (RCC) has not been evaluated in randomized controlled trials. Agents that target tyrosine kinases, mammalian target of rapamycin signaling, and immune checkpoints are now commonly used. Variables like sarcopenia, nutritional status, and frailty may impact recovery from spine surgery and are considered when evaluating a patient’s candidacy for such treatments. A better understanding of the significance of these variables may help improve patient selection for available treatment options after surgery. The authors used comparative effectiveness methods to study the treatment effect of postoperative systemic therapies (PSTs) on survival. METHODS Univariable and multivariable Cox regression analyses were performed to determine factors associated with overall survival (OS) in a retrospective cohort of adult patients who underwent spine surgery for metastatic RCC between 2010 and 2019. Propensity score–matched (PSM) analysis and inverse probability weighting (IPW) were performed to determine the treatment effect of PST on OS. To address confounding and minimize bias in estimations, PSM and IPW were adjusted for covariates, including age, sex, frailty, sarcopenia, nutrition, visceral metastases, International Metastatic RCC Database Consortium (IMDC) risk score, and performance status. RESULTS In total, 88 patients (73.9% male; median age 62 years, range 29–84 years) were identified; 49 patients (55.7%) had an intermediate IMDC risk, and 29 (33.0%) had a poor IMDC risk. The median follow-up was 17 months (range 1–104 months) during which 57 patients (64.7%) died. Poor IMDC risk (HR 3.2 [95% CI 1.08–9.3]), baseline performance status (Eastern Cooperative Oncology Group score 3 or 4; HR 2.7 [95% CI 1.5–4.7]), and nutrition (prognostic nutritional index [PNI] first tertile, PNI < 40.74; HR 2.69 [95% CI 1.42–5.1]) were associated with worse OS. Sarcopenia and frailty were not significantly associated with poor survival. PST was associated with prolonged OS, demonstrated by similar effects from multivariable Cox analysis (HR 0.55 [95% CI 0.30–1.00]), PSM (HR 0.53 [95% CI 0.29–0.93]), IPW (HR 0.47 [95% CI 0.24–0.94]), and comparable confidence intervals. The median survival for those receiving PST was 28 (95% CI 19–43) months versus 12 (95% CI 4–37) months for those who only had surgery (log-rank p = 0.027). CONCLUSIONS This comparative analysis demonstrated that PST is associated with improved survival in specific cohorts with metastatic spinal RCC after adjusting for frailty, sarcopenia, and malnutrition. The marked differences in survival should be taken into consideration when planning for surgery.

scholarly journals Real-world use of temsirolimus in Japanese patients with unresectable or metastatic renal cell carcinoma: recent consideration based on the results of a post-marketing, all-case surveillance study

2020 ◽  
Vol 50 (8) ◽  
pp. 940-947
Author(s):  
Shigeru Sugiyama ◽  
Kazuo Sato ◽  
Yoshiyuki Shibasaki ◽  
Yutaka Endo ◽  
Taku Uryu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Interstitial Lung Disease ◽  
Confidence Interval ◽  
Lung Disease ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Data Set

Abstract Objective A prospective, observational, post-marketing surveillance was conducted to assess the safety and effectiveness of temsirolimus in patients with renal cell carcinoma in Japan. Methods Patients prescribed temsirolimus for advanced renal cell carcinoma were registered and received temsirolimus (25 mg weekly, intravenous infusion for 30–60 minutes) in routine clinical settings (observation period: 96 weeks). Results Among 1001 patients included in the safety analysis data set (median age, 65.0 years; men, 74.8%; Eastern Cooperative Oncology Group performance status 0 or 1, 69.6%), 778 (77.7%) reported adverse drug reactions. The most common (≥10%) all-grade adverse drug reactions were stomatitis (26.7%), interstitial lung disease (17.3%) and platelet count decreased (11.1%). The incidence rate of grade ≥3 interstitial lung disease was 4.5%. The onset of interstitial lung disease was more frequent after 4–8 weeks of treatment or in patients with lower Eastern Cooperative Oncology Group performance status (21.6% for score 0 vs 8.3% for score 4, P &lt; 0.001). Among 654 patients in the effectiveness analysis data set, the response and clinical benefit rates were 6.7% (95% confidence interval 4.9–8.9) and 53.2% (95% confidence interval 49.3–57.1), respectively. The median progression-free survival was 18.3 weeks (95% confidence interval 16.9–21.1). Conclusions The safety and effectiveness profile of temsirolimus observed in this study was similar to that observed in the multinational phase 3 study. The results are generalizable to the real-world scenario at the time of this research, and safety and effectiveness of temsirolimus as a subsequent anticancer therapy for renal cell carcinoma warrants further investigation. (ClinicalTrials.gov identifier NCT01210482, NCT01420601).

Phase II Trial of Radiosurgery for One to Three Newly Diagnosed Brain Metastases From Renal Cell Carcinoma, Melanoma, and Sarcoma: An Eastern Cooperative Oncology Group Study (E 6397)

2005 ◽  
Vol 23 (34) ◽  
pp. 8870-8876 ◽  
Author(s):  
Rafael Manon ◽  
Anne O'Neill ◽  
Jonathan Knisely ◽  
Maria Werner-Wasik ◽  
Hillard M. Lazarus ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Brain Metastases ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Whole Brain Radiotherapy ◽  
Phase Iii ◽  
Leptomeningeal Disease ◽  
Survival Difference

Purpose Long-term brain metastases survivors are at risk for neurologic morbidity after whole-brain radiotherapy (WBRT). Retrospective radiosurgery (RS) reports found no survival difference when compared with WBRT. Before RS alone was evaluated with delayed WBRT in a phase III trial, the feasibility of RS alone was tested prospectively. Patients and Methods Patients with renal cell carcinoma, melanoma, or sarcoma; one to three brain metastases; and performance status of 0 to 2 were enrolled. Exclusion criteria were leptomeningeal disease; metastases in medulla, pons, or midbrain; or liver metastases. On the basis of tumor size, patients received 24, 18, or 15 Gy RS. At recurrence, management was discretionary. The primary end point was 3- and 6-month intracranial progression. Results Between July 1998 and August 2003, 36 patients were accrued; 31 were eligible. Median follow-up was 32.7 months and the median survival was 8.3 months (95% CI, 7.4 to 12.2). Three- and 6-month intracranial failure with RS alone was 25.8% and 48.3%. Failure within and outside the RS volume, when in-field and distant intracranial failures were scored independently, was 19.3% and 16.2% (3 months) and 32.2% and 32.2% (6 months), respectively. Approximately 38% of patients experienced death attributable to neurologic cause. There were three grade 3 toxicities related to RS. Conclusion Intracranial failure rates without WBRT were 25.8% and 48.3% at 3 and 6 months, respectively. Delaying WBRT may be appropriate for some subgroups of patients with radioresistant tumors, but routine avoidance of WBRT should be approached judiciously.

Mathematical Model to Predict Individual Survival for Patients With Renal Cell Carcinoma

2002 ◽  
Vol 20 (5) ◽  
pp. 1368-1374 ◽  
Author(s):  
Amnon Zisman ◽  
Allan J. Pantuck ◽  
Fredrick Dorey ◽  
Debby H. Chao ◽  
Barbara J. Gitlitz ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Los Angeles ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Group Performance ◽  
Performance Status ◽  
Univariate Analysis ◽  
Eastern Cooperative Oncology Group ◽  
Specific Patient ◽  
Time To Death

PURPOSE: To develop a multivariate model and mathematical formula capable of calculating personalized survival for renal cell carcinoma (RCC) patients with clinically available variables. PATIENTS AND METHODS: A total of 477 patients out of 661 undergoing nephrectomy at the University of California Los Angeles between 1989 and 1999 were eligible for evaluation and formed the analyzed cohort for this retrospective study. Time to death was the primary end point assessed. Univariate analysis for 14 to 20 variables was conducted, followed by a multivariate Cox analysis. The variables that provided independent information as to the time of death for metastatic and nonmetastatic patients were coded and incorporated into a function based on the Nadas equation principle. RESULTS: For nonmetastatic patients, the significant variables in the multivariate analysis were Fuhrman’s grade and Eastern Cooperative Oncology Group performance status. For the metastatic patients, Fuhrman’s grade, 1997 classification T stage, number of symptoms, nodal involvement, and immunotherapy were independent predictors for survival. These variables, based on the Cox multivariate regression model, were implanted into an exponential Nadas equation. The expected survival predicted by use of the Nadas equations faithfully describes the actual survival based on Kaplan-Meier curves. CONCLUSION: We have developed mathematical equations for estimating survival after radical nephrectomy for RCC. The resulting formulas are capable of better tailoring survival estimates for a specific patient and are based on widely accepted clinical prognostic variables. On validation with external data, this type of representation can be used as a tool for the determination of personalized prognosis and may be useful for patient education and counseling.

EASTERN COOPERATIVE ONCOLOGY GROUP PERFORMANCE STATUS PREDICTS BONE METASTASIS IN PATIENTS PRESENTING WITH RENAL CELL CARCINOMA: IMPLICATION FOR PREOPERATIVE BONE SCANS

2004 ◽  
Vol 172 (3) ◽  
pp. 867-870 ◽  
Author(s):  
OLEG SHVARTS ◽  
JOHN S. LAM ◽  
HYUNG L. KIM ◽  
KEN-RYU HAN ◽  
ROBERT FIGLIN ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Bone Metastasis ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Oncology Group ◽  
Bone Scans

Young Age as Favorable Prognostic Factor for Cancer-specific Survival in Localized Renal Cell Carcinoma

Urology ◽  
2011 ◽  
Vol 77 (4) ◽  
pp. 842-847 ◽  
Author(s):  
Yoshinobu Komai ◽  
Yasuhisa Fujii ◽  
Yasumasa Iimura ◽  
Manabu Tatokoro ◽  
Kazutaka Saito ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Young Age ◽  
Cancer Specific Survival ◽  
Favorable Prognostic Factor ◽  
Localized Renal Cell Carcinoma
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