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
. 2024 Jan 11;24(1):13.
doi: 10.1186/s12894-024-01403-0.

Anemia in patients ≥ 75 years with metastatic clear cell renal cell carcinoma: an important poor prognostic factor in the international metastatic renal cell carcinoma database consortium model

Ryuichi Mizuno  1 , Yota Yasumizu  2 , Nobuyuki Tanaka  2 , Toshikazu Takeda  2 , Shinya Morita  2 , Kazuhiro Matsumoto  2 , Takeo Kosaka  2 , Hiroshi Asanuma  2 , Mototsugu Oya  2
Affiliations

Anemia in patients ≥ 75 years with metastatic clear cell renal cell carcinoma: an important poor prognostic factor in the international metastatic renal cell carcinoma database consortium model

Ryuichi Mizuno et al. BMC Urol. .

Abstract

Background: Due to an increase in life expectancy, the incidence of metastatic renal cell carcinoma (mRCC) in patients aged ≥75 years has been increasing. In this study we investigated the characteristics before treatment and the outcomes of systemic therapies for patients aged ≥75 years with mRCC and compared the results with those for patients aged < 75 years in order to determine whether differences in age influenced survival.

Methods: A total of 206 consecutive Japanese patients with mRCC, including 47 patients aged ≥75 years, who received systemic therapy were included. Clinical data from medical records were retrieved and analyzed retrospectively. Survival analyses were determined using a Kaplan-Meier method, and analyzed with a log-rank test.

Results: Elderly patients categorized as favorable risk group based on the International Metastatic RCC Database Consortium (IMDC) stratification system were significantly lower. Among IMDC risk factors, the rate of anemia was significantly higher in elderly patients. No statistically significant benefit in progression free survival for first and second line treatment was observed, whereas improvements in overall survival as well as cancer specific survival were seen in patients aged < 75 years.

Conclusions: For mRCC patients aged ≥75 years, a higher proportion of base line anemia, which resulted in higher rates of IMDC intermediate/poor risk, would be responsible for shorter OS/CSS. Furthermore, mRCC patients aged ≥75 years tend to receive BSC instead of second line active treatment. Overcoming under-treatment in elderly patients might help to prolong survival in mRCC.

Keywords: Elderly; Kidney cancer; Prognosis.

PubMed Disclaimer

Conflict of interest statement

R. Mizuno MD has received honoraria from Bristol, Ono, Merck, Takeda, and Pfizer. M. Oya MD has received honoraria from Bayer, Bristol, Novartis, Ono, Merck, Takeda, MSD, and Pfizer. Other authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves showing PFS, OS, and CSS. Kaplan-Meier curves for (A) PFS for first-line systemic therapy, (B) PFS for second-line systemic therapy, (C) OS from the initiation of first-line systemic therapy, and (D) CSS from the initiation of first-line systemic therapy in mRCC patients ≥75 years and those < 75 years. + censored case
Fig. 2
Fig. 2
Sankey diagrams showing treatment flow. First- to second-line treatment flow in mRCC patients (A) ≥ 75 years and (B) < 75 years. Elderly patients were more likely to receive BSC instead of active second-line therapy
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Choueiri TK, Motzer RJ. Systemic therapy for metastatic renal-cell carcinoma. N Engl J Med. 2017;376(4):354–366. doi: 10.1056/NEJMra1601333. - DOI - PubMed
    1. Motzer RJ, Tannir NM, McDermott DF, Aren Frontera O, Melichar B, Choueiri TK, et al. Nivolumab plus Ipilimumab versus Sunitinib in advanced renal-cell carcinoma. N Engl J Med. 2018;378(14):1277–1290. doi: 10.1056/NEJMoa1712126. - DOI - PMC - PubMed
    1. Rini BI, Plimack ER, Stus V, Gafanov R, Hawkins R, Nosov D, et al. Pembrolizumab plus Axitinib versus Sunitinib for advanced renal-cell carcinoma. N Engl J Med. 2019;380(12):1116–1127. doi: 10.1056/NEJMoa1816714. - DOI - PubMed
    1. Choueiri TK, Powles T, Burotto M, Escudier B, Bourlon MT, Zurawski B, et al. Nivolumab plus Cabozantinib versus Sunitinib for advanced renal-cell carcinoma. N Engl J Med. 2021;384(9):829–841. doi: 10.1056/NEJMoa2026982. - DOI - PMC - PubMed
    1. Motzer R, Alekseev B, Rha SY, Porta C, Eto M, Powles T, et al. Lenvatinib plus Pembrolizumab or Everolimus for advanced renal cell carcinoma. N Engl J Med. 2021;384(14):1289–1300. doi: 10.1056/NEJMoa2035716. - DOI - PubMed

Supplementary concepts