Survival and clinical prognostic factors in metastatic non-clear cell renal cell carcinoma treated with targeted therapy

A multi-institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

Jung Kwon Kim, Sung Han Kim, Mi Kyung Song, Jungnam Joo, Seong Il Seo, Cheol Kwak, Chang Wook Jeong, Cheryn Song, Eu Chang Hwang, Ill Young Seo, Hakmin Lee, Sung Hoo Hong, Jae Young Park, Jinsoo Chung

Research output: Contribution to journalArticle

Abstract

Objectives: The optimal treatment strategy for metastatic non-clear cell renal cell carcinoma (mNCCRCC) is still elusive and mainly extrapolated from evidence available for metastatic clear cell renal cell carcinoma. The aim of the study was therefore to investigate the survival outcomes and prognostic factors affecting survival in patients with mNCCRCC treated with targeted therapy. Materials and methods: We analyzed a total of 156 patients (8.1%) with mNCCRCC among the total cohort of 1922 patients in the Korean metastatic RCC registry. We used Kaplan-Meier curve analysis to calculate the survival estimates for first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS). We also used the log-rank test to compare the different groups and multivariate Cox-proportional hazard regression analyses to evaluate the prognostic factors for survival. Results: The mNCCRCC group had significantly inferior survival outcomes in terms of first-line PFS, total PFS, and CSS (all P < 0.05). We found survival benefits in patients treated with first-line vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs, first-line PFS, and total PFS, all P < 0.05), cytoreductive nephrectomy (CSS, P < 0.0001), metastasectomy (CSS, P = 0.0017), and patients with metachronous metastasis (first-line PFS, total PFS, and CSS, all P < 0.05). Liver metastasis was the only significant prognostic factor for both first-line PFS and CSS (all P < 0.05). Conclusions: In the current targeted therapy era, survival of mNCCRCC is still inferior in comparison with that of mCCRCC patients. We found survival benefits in patients treated with first-line VEGF-TKIs/CN/metastasectomy, and metachronous metastasis patients.

Original languageEnglish
Pages (from-to)3401-3410
Number of pages10
JournalCancer Medicine
Volume8
Issue number7
DOIs
Publication statusPublished - 2019 Jul 1

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Renal Cell Carcinoma
Registries
Retrospective Studies
Survival
Disease-Free Survival
Therapeutics
Metastasectomy
Vascular Endothelial Growth Factor A
Neoplasms
Neoplasm Metastasis
Clear-cell metastatic renal cell carcinoma
Kaplan-Meier Estimate
Nephrectomy
Protein-Tyrosine Kinases
Regression Analysis

Keywords

  • Korean
  • metastatic renal cell carcinoma
  • non-clear cell
  • prognosis
  • survival

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Survival and clinical prognostic factors in metastatic non-clear cell renal cell carcinoma treated with targeted therapy : A multi-institutional, retrospective study using the Korean metastatic renal cell carcinoma registry. / Kim, Jung Kwon; Kim, Sung Han; Song, Mi Kyung; Joo, Jungnam; Seo, Seong Il; Kwak, Cheol; Jeong, Chang Wook; Song, Cheryn; Hwang, Eu Chang; Seo, Ill Young; Lee, Hakmin; Hong, Sung Hoo; Park, Jae Young; Chung, Jinsoo.

In: Cancer Medicine, Vol. 8, No. 7, 01.07.2019, p. 3401-3410.

Research output: Contribution to journalArticle

Kim, Jung Kwon ; Kim, Sung Han ; Song, Mi Kyung ; Joo, Jungnam ; Seo, Seong Il ; Kwak, Cheol ; Jeong, Chang Wook ; Song, Cheryn ; Hwang, Eu Chang ; Seo, Ill Young ; Lee, Hakmin ; Hong, Sung Hoo ; Park, Jae Young ; Chung, Jinsoo. / Survival and clinical prognostic factors in metastatic non-clear cell renal cell carcinoma treated with targeted therapy : A multi-institutional, retrospective study using the Korean metastatic renal cell carcinoma registry. In: Cancer Medicine. 2019 ; Vol. 8, No. 7. pp. 3401-3410.
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abstract = "Objectives: The optimal treatment strategy for metastatic non-clear cell renal cell carcinoma (mNCCRCC) is still elusive and mainly extrapolated from evidence available for metastatic clear cell renal cell carcinoma. The aim of the study was therefore to investigate the survival outcomes and prognostic factors affecting survival in patients with mNCCRCC treated with targeted therapy. Materials and methods: We analyzed a total of 156 patients (8.1{\%}) with mNCCRCC among the total cohort of 1922 patients in the Korean metastatic RCC registry. We used Kaplan-Meier curve analysis to calculate the survival estimates for first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS). We also used the log-rank test to compare the different groups and multivariate Cox-proportional hazard regression analyses to evaluate the prognostic factors for survival. Results: The mNCCRCC group had significantly inferior survival outcomes in terms of first-line PFS, total PFS, and CSS (all P < 0.05). We found survival benefits in patients treated with first-line vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs, first-line PFS, and total PFS, all P < 0.05), cytoreductive nephrectomy (CSS, P < 0.0001), metastasectomy (CSS, P = 0.0017), and patients with metachronous metastasis (first-line PFS, total PFS, and CSS, all P < 0.05). Liver metastasis was the only significant prognostic factor for both first-line PFS and CSS (all P < 0.05). Conclusions: In the current targeted therapy era, survival of mNCCRCC is still inferior in comparison with that of mCCRCC patients. We found survival benefits in patients treated with first-line VEGF-TKIs/CN/metastasectomy, and metachronous metastasis patients.",
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author = "Kim, {Jung Kwon} and Kim, {Sung Han} and Song, {Mi Kyung} and Jungnam Joo and Seo, {Seong Il} and Cheol Kwak and Jeong, {Chang Wook} and Cheryn Song and Hwang, {Eu Chang} and Seo, {Ill Young} and Hakmin Lee and Hong, {Sung Hoo} and Park, {Jae Young} and Jinsoo Chung",
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T1 - Survival and clinical prognostic factors in metastatic non-clear cell renal cell carcinoma treated with targeted therapy

T2 - A multi-institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

AU - Kim, Jung Kwon

AU - Kim, Sung Han

AU - Song, Mi Kyung

AU - Joo, Jungnam

AU - Seo, Seong Il

AU - Kwak, Cheol

AU - Jeong, Chang Wook

AU - Song, Cheryn

AU - Hwang, Eu Chang

AU - Seo, Ill Young

AU - Lee, Hakmin

AU - Hong, Sung Hoo

AU - Park, Jae Young

AU - Chung, Jinsoo

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objectives: The optimal treatment strategy for metastatic non-clear cell renal cell carcinoma (mNCCRCC) is still elusive and mainly extrapolated from evidence available for metastatic clear cell renal cell carcinoma. The aim of the study was therefore to investigate the survival outcomes and prognostic factors affecting survival in patients with mNCCRCC treated with targeted therapy. Materials and methods: We analyzed a total of 156 patients (8.1%) with mNCCRCC among the total cohort of 1922 patients in the Korean metastatic RCC registry. We used Kaplan-Meier curve analysis to calculate the survival estimates for first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS). We also used the log-rank test to compare the different groups and multivariate Cox-proportional hazard regression analyses to evaluate the prognostic factors for survival. Results: The mNCCRCC group had significantly inferior survival outcomes in terms of first-line PFS, total PFS, and CSS (all P < 0.05). We found survival benefits in patients treated with first-line vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs, first-line PFS, and total PFS, all P < 0.05), cytoreductive nephrectomy (CSS, P < 0.0001), metastasectomy (CSS, P = 0.0017), and patients with metachronous metastasis (first-line PFS, total PFS, and CSS, all P < 0.05). Liver metastasis was the only significant prognostic factor for both first-line PFS and CSS (all P < 0.05). Conclusions: In the current targeted therapy era, survival of mNCCRCC is still inferior in comparison with that of mCCRCC patients. We found survival benefits in patients treated with first-line VEGF-TKIs/CN/metastasectomy, and metachronous metastasis patients.

AB - Objectives: The optimal treatment strategy for metastatic non-clear cell renal cell carcinoma (mNCCRCC) is still elusive and mainly extrapolated from evidence available for metastatic clear cell renal cell carcinoma. The aim of the study was therefore to investigate the survival outcomes and prognostic factors affecting survival in patients with mNCCRCC treated with targeted therapy. Materials and methods: We analyzed a total of 156 patients (8.1%) with mNCCRCC among the total cohort of 1922 patients in the Korean metastatic RCC registry. We used Kaplan-Meier curve analysis to calculate the survival estimates for first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS). We also used the log-rank test to compare the different groups and multivariate Cox-proportional hazard regression analyses to evaluate the prognostic factors for survival. Results: The mNCCRCC group had significantly inferior survival outcomes in terms of first-line PFS, total PFS, and CSS (all P < 0.05). We found survival benefits in patients treated with first-line vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs, first-line PFS, and total PFS, all P < 0.05), cytoreductive nephrectomy (CSS, P < 0.0001), metastasectomy (CSS, P = 0.0017), and patients with metachronous metastasis (first-line PFS, total PFS, and CSS, all P < 0.05). Liver metastasis was the only significant prognostic factor for both first-line PFS and CSS (all P < 0.05). Conclusions: In the current targeted therapy era, survival of mNCCRCC is still inferior in comparison with that of mCCRCC patients. We found survival benefits in patients treated with first-line VEGF-TKIs/CN/metastasectomy, and metachronous metastasis patients.

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KW - metastatic renal cell carcinoma

KW - non-clear cell

KW - prognosis

KW - survival

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