Prognostic factors for overall survival in patients with clear cell metastatic renal cell carcinoma

Shin, Dongrul; Jeong, Chang Wook; Song, Cheryn; Kang, Minyong; Seo, Seong Il; Kim, Jung Kwon; Lee, Hakmin; Chung, Jinsoo; Hong, Sung Hoo; Hwang, Eu Chang; Kwak, Cheol; Park, Jae Young

doi:10.1097/md.0000000000026826

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…The following agreements were made before initiating medication and repeated during treatment based on the decision by each physician: entire medical history, physical checkup, ECOG PS, blood cell counts, biochemical profile (including electrolytes, kidney and liver function, coagulation, pancreatic amylase, and lipase), urinalyses, and radiography. Three simple candidates of biomarkers (neutrophil–lymphocyte ratio, 13 C‐reactive protein, 14 and alkaline phosphatase 15 ) as predictive markers were analyzed. Tumor response was evaluated using the Response Evaluation Criteria in Solid Tumors guidelines version 1.1.…”

Section: Methodsmentioning

confidence: 99%

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Clinical impact of early response to first‐line VEGFR‐TKI in patients with metastatic renal cell carcinoma on survival: A multi‐institutional retrospective study

et al. 2022

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It remains unknown whether the early response to vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR‐TKI) management in malignancies links to long‐term survival. The objective of this study was to investigate the survival rates and predictive factors of early response in patients with metastatic renal cell carcinoma (mRCC) managed by VEGFR‐TKIs. From Jan. 2008 to Oct. 2018, 496 patients were treated with VEGFR‐TKIs as first‐line treatment at the eight Japanese hospitals (Michinoku RCC). Early cessation was defined as VEGFR‐TKIs being given up within 3 months after their initiation. The number of patients in early cessation VEGFR‐TKIs (Cohort I) was 173 (34.9%), and in long‐term use (Cohort II) was 323 (65.1%). The cancer‐specific survival (CSS) and overall survival (OS) were better in Cohort II. IMDC Poor‐risk was at risk of early cessation of a first‐line VEGFR‐TKI. Axitinib was the most preferred drug for long‐term treatment. On closer examination, both Cohort I and II were divided into two groups, the patients ceased VEGFR‐TKI due to adverse events (Group A [67 from Cohort I] and Group C [51 from Cohort II]) and disease progression (Group B [106 from Cohort I] and Group D [272 from Cohort II]). Despite that the cessation was adverse events, CSS and OS in Group A were worse than both Group C and D. Axitinib was administered with the safer profile. IMDC Poor risk was the risk factor for the early disease progression. Managing early adverse events may contribute to a better prognosis in mRCC patients treated VEGFR‐TKIs.

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Section: Methodsmentioning

confidence: 99%

“…axitinib, early response, metastatic renal cell carcinoma, VEGFR-TKI ratio, 13 C-reactive protein, 14 and alkaline phosphatase 15 ) as predictive markers were analyzed. Tumor response was evaluated using the Response Evaluation Criteria in Solid Tumors guidelines version 1.1.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of early response to first‐line VEGFR‐TKI in patients with metastatic renal cell carcinoma on survival: A multi‐institutional retrospective study

et al. 2022

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Evaluating the Prognostic Variables for Overall Survival in Patients with Metastatic Renal Cell Carcinoma: A Meta-Analysis Of 29,366 Patients

Li,

Sood,

Huynh

et al. 2024

JU Open Plus

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Background: Scoring systems are a method of risk assessment used to stratify patients with metastatic renal cell carcinoma (mRCC) and guide systemic therapy. The variables are weighed equally when calculating total score. However, the difference of even 1 positive predictor can change one's risk category and therapy. Objective: To compare the relative strength of association between predictive variables and overall survival (OS) in mRCC. Methods: A search of Medical Literature Analysis and Retrieval System Online (MEDLINE) and Embase was conducted. Clinical studies, retrospective and prospective, were included if the association of at least 1 predictor and OS in patients with mRCC receiving first-line systemic therapy was evaluated. Meta-analysis was performed to generate pooled hazard ratios (HRs) and 95% CIs for OS for predictors with ≥ 5 included studies. Sensitivity analysis identified outlier heterogeneity and publication bias. Results: Sixty-six studies containing 29,366 patients were included. Meta-analysis indicated lung metastases, bone metastases, thrombocytosis, time to systemic therapy < 1 year, liver metastases, hypercalcemia, anemia, elevated neutrophil-lymphocyte ratio, multiple metastatic sites, neutrophilia, poor Eastern Cooperative Oncology Group (ECOG) status, no previous nephrectomy, elevated lactate dehydrogenase, Fuhrman grade 3 or 4, central nervous system metastases, elevated C-reactive protein, and Karnofsky Performance Status < 80% were associated with significantly worse OS. The HRs varied from 1.34 to 2.76, representing heterogeneity in predictive strength. The effects of study heterogeneity and publication bias were minimal to moderate across all predictors. Conclusions: Based on the differences in pooled HRs, prognostic strength between the variables is likely not equivalent. Restructuring scoring models, through inclusion of other variables and usage of relative weighting, should be considered to improve accuracy of risk stratification.

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The predictive accuracy of preoperative erythrocyte count and maximum tumor diameter to maximum kidney diameter ratio in renal cell carcinoma

Zhang¹,

Yan²,

Xu³

et al. 2022

Transl Androl Urol

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Background: The purpose of this study was to investigate the predictive accuracy of erythrocyte count and maximum tumor diameter to maximum kidney diameter ratio (TKR) in patients with renal cell carcinoma (RCC). Methods:We retrospectively analyzed the clinicopathological epidemiological characteristics of patients with RCC in the First Hospital of Shanxi Medical University from 2010 to 2014. Among them, 295 cases with complete follow-up data at the time of visit were selected. We collected data including erythrocyte counts and length of each diameter line of the tumor and kidney. To predict the prognosis of RCC, receiver operating characteristic (ROC) curve analysis was used to calculate the cutoff value of each parameter.Results: Of the 295 included patients, 199 (67.5%) were male, 96 (32.5%) were female, and the mean (± SD) age was 56.45±11.03 years. The area under the curve (AUC) of the erythrocyte count and the TKR for predicting the prognosis of RCC were 0.672 (SD 0.031; P<0.001) and 0.800 (SD 0.030; P<0.001), respectively. When the cutoff value of the erythrocyte count and TKR count were 3.975 and 0.452, the highest Youden index values were 0.309 and 0.685, and the corresponding sensitivity and specificity were 0.826 and 0.685, and 0.483 and 1.000, respectively.Conclusions: An erythrocyte count <3.975×10 12 /L and a TKR >0.452 were found to be risk factors for poor prognosis in patients with RCC.

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Prognostic factors for overall survival in patients with clear cell metastatic renal cell carcinoma

Cited by 3 publications

References 30 publications

Clinical impact of early response to first‐line VEGFR‐TKI in patients with metastatic renal cell carcinoma on survival: A multi‐institutional retrospective study

Clinical impact of early response to first‐line VEGFR‐TKI in patients with metastatic renal cell carcinoma on survival: A multi‐institutional retrospective study

Evaluating the Prognostic Variables for Overall Survival in Patients with Metastatic Renal Cell Carcinoma: A Meta-Analysis Of 29,366 Patients

The predictive accuracy of preoperative erythrocyte count and maximum tumor diameter to maximum kidney diameter ratio in renal cell carcinoma

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