Background: The prognostic significance of number and location of organ-specific metastatic sites in treated metastatic clear cell renal carcinoma (ccmRCC) patients is object of debate. The current study aimed to test the association between number and location of organ-specific metastatic sites and overall survival (OS) in ccmRCC. Materials and methods: Within Surveillance, Epidemiology and End Results database (2010–2018), all ccmRCC patients treated with cytoreductive nephrectomy and/or systemic therapy were identified. Kaplan-Meier plots and Cox regression models focused on: A). number of organ-specific metastatic sites: solitary vs. 2 vs. 3 or more; B). solitary organ-specific metastatic sites (lung vs. bone vs. liver vs. brain); C). combinations of 2 and 3 or more different organ-specific metastatic sites. Results: Of 4,527 patients (median OS: 19 months), 3,054 (67%) harbored solitary organ-specific metastatic sites (27 months) vs. 1,153 (25%) combinations of 2 different organ-specific metastatic sites (12 months) vs. 320 (8%) combinations of 3 or more different organ-specific metastatic sites (7 months). In patients with solitary organ-specific metastatic sites, bone metastases portended the longest median OS (median OS: 31 months) vs. liver metastases portended the shortest median OS (16 months). Both were independent predictors of OS (multivariable hazard ratio, bone: 0.87; liver: 1.21). Median OS was similarly poor in patients with combinations of 2 different organ-specific metastatic sites (9–13 months), regardless of their location. The same pattern applied to patients with combinations of 3 or more different organ-specific metastatic sites (6–7 months). Conclusions: Solitary organ-specific metastatic sites portend the most favorable OS (16–31 months). Solitary bone metastases yield the longest vs. liver metastases the shortest OS. Invariably poor OS applies to combinations of 2 (9–13 months), as well as 3 or more different organ-specific metastatic sites (6–7 months), regardless of their location.
Survival of patients with clear cell renal carcinoma according to number and location of organ-specific metastatic sites / Tappero, S., Barletta, F., Piccinelli, M.L., Cano Garcia, C., Incesu, R.-B., Morra, S., Scheipner, L., Baudo, A., Tian, Z., Parodi, S., Dell'Oglio, P., Briganti, A., de Cobelli, O., Chun, F.K.H., Graefen, M., Longo, N., Ahyai, S., Carmignani, L., Saad, F., Shariat, S.F., et al.. - In: UROLOGIC ONCOLOGY. - ISSN 1078-1439. - 42:1(2024), pp. 22-22.e31. [10.1016/j.urolonc.2023.08.014]
Survival of patients with clear cell renal carcinoma according to number and location of organ-specific metastatic sites
Barletta F.;Morra S.;Longo N.;
2024
Abstract
Background: The prognostic significance of number and location of organ-specific metastatic sites in treated metastatic clear cell renal carcinoma (ccmRCC) patients is object of debate. The current study aimed to test the association between number and location of organ-specific metastatic sites and overall survival (OS) in ccmRCC. Materials and methods: Within Surveillance, Epidemiology and End Results database (2010–2018), all ccmRCC patients treated with cytoreductive nephrectomy and/or systemic therapy were identified. Kaplan-Meier plots and Cox regression models focused on: A). number of organ-specific metastatic sites: solitary vs. 2 vs. 3 or more; B). solitary organ-specific metastatic sites (lung vs. bone vs. liver vs. brain); C). combinations of 2 and 3 or more different organ-specific metastatic sites. Results: Of 4,527 patients (median OS: 19 months), 3,054 (67%) harbored solitary organ-specific metastatic sites (27 months) vs. 1,153 (25%) combinations of 2 different organ-specific metastatic sites (12 months) vs. 320 (8%) combinations of 3 or more different organ-specific metastatic sites (7 months). In patients with solitary organ-specific metastatic sites, bone metastases portended the longest median OS (median OS: 31 months) vs. liver metastases portended the shortest median OS (16 months). Both were independent predictors of OS (multivariable hazard ratio, bone: 0.87; liver: 1.21). Median OS was similarly poor in patients with combinations of 2 different organ-specific metastatic sites (9–13 months), regardless of their location. The same pattern applied to patients with combinations of 3 or more different organ-specific metastatic sites (6–7 months). Conclusions: Solitary organ-specific metastatic sites portend the most favorable OS (16–31 months). Solitary bone metastases yield the longest vs. liver metastases the shortest OS. Invariably poor OS applies to combinations of 2 (9–13 months), as well as 3 or more different organ-specific metastatic sites (6–7 months), regardless of their location.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
