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. 2008 Jun 30;49(3):451-8.
doi: 10.3349/ymj.2008.49.3.451.

A comprehensive prognostic stratification for patients with metastatic renal clear cell carcinoma

Kang Su Cho  1 , Young Deuk Choi, Se Joong Kim, Chun Il Kim, Byung Ha Chung, Do Hwan Seong, Dong Hyeon Lee, Jin Seon Cho, In Rae Cho, Sung Joon Hong
Affiliations

A comprehensive prognostic stratification for patients with metastatic renal clear cell carcinoma

Kang Su Cho et al. Yonsei Med J. .

Abstract

Purpose: To develop a reliable prognostic model for patients with metastatic renal cell carcinoma (RCC) based on features readily available in common clinical settings.

Patients and methods: A total of 197 patients with RCC who underwent nephrectomy and immunotherapy from 1995 to 2004 were retrospectively reviewed. Their mean age was 55.1+/-11.8 yrs (24-83 yrs) and mean survival time from metastasis was 22.6+/-20.2 mos (3-120 mos). The impact of 24 clinicopathological features on disease specific survival was investigated.

Results: On univariate analysis, constitutional symptoms, sarcomatoid differentiation, tumor necrosis, multiple primary lesions, liver metastasis, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), thrombocytosis, alkaline phosphatase, hematocrit, T stage, N stage, and nuclear grade had significant influence on survival (p<0.05). Multivariate analysis revealed the following features associated with survival: sarcomatoid differentiation [hazard ratio (HR)=2.99, p<0.001], liver metastasis (HR=2.09, p=0.002), ECOG-PS (HR=1.95, p=0.005), N stage (HR=1.94, p=0.002), and number of metastatic sites (HR=1.76, p=0.003). An individual prognostic score was defined as the sum of the weight of these features. According to prognostic scores, patients could be subdivided into 3 groups: low risk (score 0), intermediate risk (score 1 or 2), and high risk (score >or= 3).

Conclusion: A comprehensive prognostic stratification model was developed to predict survival and stratify patients for prospective clinical trials.

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Figures

Fig. 1
Fig. 1
Disease-specific survival curves according to risk scores (A) and risk groups (B). p value = 0.001 between low risk and intermediate risk, p value < 0.001 between intermediate risk and high risk.
See this image and copyright information in PMC

References

    1. Motzer RJ, Bander NH, Nanus DM. Renal-cell carcinoma. N Engl J Med. 1996;335:865–875. - PubMed
    1. Pantuck AJ, Zisman A, Belldegrun AS. The changing natural history of renal cell carcinoma. J Urol. 2001;166:1611–1623. - PubMed
    1. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, et al. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med. 2001;345:1655–1659. - PubMed
    1. Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R. (European Organisation for Research and Treatment of Cancer (EORTC) Genitourinary Group). Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet. 2001;358:966–970. - PubMed
    1. Bellmunt J, Montagut C, Albiol S, Carles J, Maroto P, Orsola A. Present strategies in the treatment of metastatic renal cell carcinoma: an update on molecular targeting agents. BJU Int. 2007;99:274–280. - PubMed