Bone metastases in patients with metastatic renal cell carcinoma: are they always associated with poor prognosis?

Abstract

PurposeAim of this study was to investigate for the presence of existing prognostic factors in patients with bone metastases (BMs) from RCC since bone represents an unfavorable site of metastasis for renal cell carcinoma (mRCC).Materials and methodsData of patients with BMs from RCC were retrospectively collected. Age, sex, ECOG-Performance Status (PS), MSKCC group, tumor histology, presence of concomitant metastases to other sites, time from nephrectomy to bone metastases (TTBM, classified into three groups: <1 year, between 1 and 5 years and >5 years) and time from BMs to skeletal-related event (SRE) were included in the Cox analysis to investigate their prognostic relevance.Results470 patients were enrolled in this analysis. In 19 patients (4%),bone was the only metastatic site; 277 patients had concomitant metastases in other sites. Median time to BMs was 16 months (range 0 − 44y) with Median OS of 17 months. Number of metastatic sites (including bone, p = 0.01), concomitant metastases, high Fuhrman grade (p < 0.001) and non-clear cell histology (p = 0.013) were significantly associated with poor prognosis. Patients with TTBM >5 years had longer OS (22 months) compared to patients with TTBM <1 year (13 months) or between 1 and 5 years (19 months) from nephrectomy (p < 0.001), no difference was found between these two last groups (p = 0.18). At multivariate analysis, ECOG-PS, MSKCC group and concomitant lung or lymph node metastases were independent predictors of OS in patients with BMs.ConclusionsOur study suggest that age, ECOG-PS, histology, MSKCC score, TTBM and the presence of concomitant metastases should be considered in order to optimize the management of RCC patients with BMs.

Carcinoma de células claras renales metastásico a mama

“…El carcinoma de células renales representa aproximadamente el 5 % de todas las neoplasias epiteliales en el mundo, de las cuales el carcinoma de células claras del riñón es el tercer tumor más común del tracto genitourinario, dando cuenta de aproximadamente el 3 % de todas las neoplasias y el 85 % de los carcinomas de células renales [6][7][8][9] . Es más común en hombres que en mujeres, en una proporción de 1.5:1, y la mayoría de los casos ocurren entre los 50 a 70 años de edad.…”

Outcome of oligoprogressing metastatic renal cell carcinoma patients treated with locoregional therapy: A multicenter retrospective analysis

“…In addition, we pointed out that patients who developed bone metastases as site of oligo-progression had a trend of longer post progression mOS compared to those who developed visceral metastases. In this regard, there are opposing literature data: some studies suggest that bone metastases have a negative impact and are associated with poor clinical outcomes in patients with mRCC [25][26][27]. Others show that RCC patients with less than 5 bone metastases have favorable outcomes under therapy with sunitinib [28].…”

Imaging of Malignant Bone Tumors

“…Renal cell carcinoma accounts for approximately 5% of epithelial cancers worldwide with female bias [19][20][21]. Almost one third of patients present with synchronous metastatic disease and another 20% experience recurrence or develop metastatic renal cell carcinoma even after nephrectomy [19,21,22].…”

“…Almost one third of patients present with synchronous metastatic disease and another 20% experience recurrence or develop metastatic renal cell carcinoma even after nephrectomy [19,21,22]. Bone metastasis occurs in almost 35% of patients with advanced renal cell carcinoma [19,23,24].…”