Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May;27(5):448-456.
doi: 10.1111/iju.14215. Epub 2020 Mar 23.

New prognostic model for synchronous metastatic renal cell carcinoma

Sei Naito  1 , Tomoyuki Kato  1 , Osamu Ichiyanagi  1 , Takafumi Narisawa  1 , Masayuki Kurokawa  1 , Mayu Yagi  1 , Masaki Ushijima  1 , Michinobu Ozawa  1 , Hidenori Kanno  1 , Yuta Kurota  1 , Hiroki Fukuhara  1 , Yuya Kuboki  1 , Atsushi Yamagishi  1 , Toshihiko Sakurai  1 , Hayato Nishida  1 , Takuya Yamanobe  1 , Norihiko Tsuchiya  1
Affiliations

New prognostic model for synchronous metastatic renal cell carcinoma

Sei Naito et al. Int J Urol. 2020 May.

Abstract

Objectives: To create a new model for the prediction of overall survival in synchronous metastatic renal cell carcinoma.

Methods: Medical records of 158 patients with metastatic renal cell carcinoma diagnosed at the Yamagata University Hospital from August 2007 to February 2018 were reviewed. Among them, 77 with synchronous metastatic renal cell carcinoma were retrospectively analyzed using the univariate and multivariate analyses. A new prognostic model was constructed, followed by a bootstrap validation to estimate the model fitting. In addition, these prognostic factors were estimated in 67 metachronous metastatic renal cell carcinoma patients.

Results: Five independent prognostic factors were identified in synchronous metastatic renal cell carcinoma: cT3/4, cN1, high corrected calcium, >3.6 neutrophil-to-lymphocyte ratio and central nerve system metastasis. The number (%) and overall survival (95% confidence interval) in the favorable- (0 or 1 risk factor), intermediate- (2 risk factors) and poor-risk (≥3 risk factors) groups were 29 (45.3%) and 67.4 (31.8-NA), 21 (32.8%) and 16.8 (10.0-27.6), and 14 (21.9%) and 9.1 (7.3-13.7) months, respectively. The C-index was 0.72. Patients in the favorable-risk group had better overall survival with nephrectomy than without nephrectomy (hazard ratio 0.29, 95% confidence interval 0.09-0.91 with nephrectomy). In metachronous metastatic renal cell carcinoma, these prognostic factors showed no statistical differences in the overall survival.

Conclusions: Prognostic factors are completely different between synchronous and metachronous metastatic renal cell carcinoma. The new model for synchronous metastatic renal cell carcinoma can predict a good candidate for cytoreductive nephrectomy.

Keywords: carcinoma; kidney; overall survival; prognosis; prognostic model; renal cell; synchronous metastatic renal cell carcinoma.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Gupta K, Miller JD, Li JZ, Russell MW, Charbonneau C. Epidemiologic and socioeconomic burden of metastatic renal cell carcinoma (mRCC): a literature review. Cancer Treat. Rev. 2008; 34: 193-205.
    1. Mejean A, Ravaud A, Thezenas S et al. Sunitinib alone or after nephrectomy in metastatic renal-cell carcinoma. N. Engl. J. Med. 2018; 379: 417-27.
    1. Bex A, Albiges L, Ljungberg B et al. Updated European Association of Urology guidelines for cytoreductive nephrectomy in patients with synchronous metastatic clear-cell renal cell carcinoma. Eur. Urol. 2018; 74: 805-9.
    1. Arora S, Sood A, Dalela D et al. Cytoreductive nephrectomy: assessing the generalizability of the CARMENA trial to real-world National Cancer Data Base cases. Eur. Urol. 2019; 75: 352-3.
    1. Osawa T, Takeuchi A, Kojima T, Shinohara N, Eto M, Nishiyama H. Overview of current and future systemic therapy for metastatic renal cell carcinoma. Jpn J. Clin. Oncol. 2019; 49: 395-403.

LinkOut - more resources