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. 2021 May:7:671-685.
doi: 10.1200/GO.20.00621.

Prognostic Factors in De Novo Metastatic Renal Cell Carcinoma: A Report From the Latin American Renal Cancer Group

Diego Abreu  1 , Gustavo Carvalhal  2 , Guillermo Gueglio  3 , Ignacio Tobia  3 , Patricio Garcia  3 , Alvaro Zuñiga  4 , Luis Meza  5 , Rubén Bengió  6 , Carlos Scorticati  7 , Ricardo Castillejos  8 , Francisco Rodriguez  8 , Ana María Autran  9 , Carmen Gonzales  9 , Jose Gadu  10 , Alejandro Nolazco  11 , Carlos Ameri  12 , Hamilton Zampolli  13 , Raúl Langenhin  14 , Diego Muguruza  14 , Marcos Tobías Machado  15 , Pablo Mingote  16 , Juan Yandian  17 , Jorge Clavijo  17 , Lucas Nogueira  18 , Omar Clark  19 , Fernando Secin  20 , Agustín Rovegno  20 , Ana Vilas  21 , Enrique Barrios  22 , Ricardo Decia  1 , Gustavo Guimarães  23 , Sidney Glina  24 , Sumanta K Pal  25 , Oscar Rodriguez  26 , Joan Palou  26 , Philippe Spiess  27 , Primo N Lara Jr  28 , W Marston Linehan  29 , Antonio Luigi Pastore  30 , Stenio C Zequi  23
Affiliations

Prognostic Factors in De Novo Metastatic Renal Cell Carcinoma: A Report From the Latin American Renal Cancer Group

Diego Abreu et al. JCO Glob Oncol. 2021 May.

Abstract

Purpose: To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries.

Patients and methods: Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method.

Results: Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58).

Conclusion: Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.

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Conflict of interest statement

Francisco RodriguezHonoraria: Astellas Pharma, Bayer, Asofarma, Ferring, GlaxoSmithKline, Janssen-Cilag, Lilly, MSD OncologyConsulting or Advisory Role: Astellas Pharma, Asofarma, GlaxoSmithKline, Janssen Oncology, MSD OncologySpeakers' Bureau: Astellas Pharma, Asofarma, Bayer, Janssen Oncology, MSD OncologyTravel, Accommodations, Expenses: Janssen Oncology, Asofarma Jose GaduSpeakers' Bureau: Janssen, Bayer Hamilton ZampolliHonoraria: Janssen OncologyConsulting or Advisory Role: Janssen Oncology Lucas NogueiraConsulting or Advisory Role: BayerSpeakers' Bureau: Bayer, Astellas Pharma Agustin RovegnoEmployment: Abbott LaboratoriesHonoraria: Baliarda SA Sidney GlinaHonoraria: Pfizer Sumanta K. PalConsulting or Advisory Role: Pfizer, Novartis, Aveo, Myriad Pharmaceuticals, Genentech, Exelixis, Bristol Myers Squibb, Astellas Pharma, Ipsen, Eisai Philippe SpiessLeadership: NCCN, Global Society of Rare Genitourinary TumorsHonoraria: UpToDateOther Relationship: NCCNUncompensated Relationships: Moffitt Primo N. LaraConsulting or Advisory Role: Janssen, Calithera BiosciencesResearch Funding: Janssen Biotech, Merck, Pharmacyclics, Incyte, Taiho Pharmaceutical Stenio C. ZequiConsulting or Advisory Role: Pfizer, Astellas BrazilSpeakers' Bureau: Pfizer, Astellas Pharma, Bayer, Janssen, Astra Zeneca BrazilNo other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
OS for the entire patient cohort. OS, overall survival.
FIG 2
FIG 2
OS and CSS in relation to the presence of a single metastasis versus multiple metastases. CSS, cancer-specific survival; HR, hazard ratio; OS, overall survival.
FIG 3
FIG 3
OS and CSS in relation to the metastasis in a single-organ versus metastatic involvement of two or more organs. CSS, cancer-specific survival; HR, hazard ratio; OS, overall survival.
FIG 4
FIG 4
OS and CSS in relation to the presence of bone versus lung metastasis. CSS, cancer-specific survival; HR, hazard ratio; OS, overall survival.
FIG 5
FIG 5
OS and CSS in relation to the presence of nonvertebral versus vertebral bone metastasis. CSS, cancer-specific survival; HR, hazard ratio; OS, overall survival.
FIG 6
FIG 6
OS and CSS in relation to the presence of ≤ 5 versus > 5 lung metastases. CSS, cancer-specific survival; HR, hazard ratio; OS, overall survival.
FIG 7
FIG 7
OS and CSS in relation to the number of lung metastases. CSS, cancer-specific survival; OS, overall survival.
FIG 8
FIG 8
OS and CSS in relation to the presence of > 10 lung metastases versus metastatic involvement of two or more organs. CSS, cancer-specific survival; HR, hazard ratio; OS, overall survival.
FIG 9
FIG 9
OS and CSS in relation to the receipt of systemic therapy (IT and targeted therapy). CSS, cancer-specific survival; HR, hazard ratio; IT, immunotherapy; OS, overall survival; ST, systemic treatment; VEGF, vascular endothelial growth factor.
FIG 10
FIG 10
OS according to three risk groups. ASA, American Society of Anesthesiology; HR, hazard ratio; NR, no response; OS, overall survival.
See this image and copyright information in PMC

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