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Outcome of patients with metastatic sarcomatoid renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium

Title
Outcome of patients with metastatic sarcomatoid renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium
Authors
Christos E. Kyriakopoulos;Namita Chittoria;Brian I. Rini;Daniel Y. Heng;Scott A. North;Frede Donskov;Takeshi Yuasa;Sun-Young Rha;Ravindran Kanesvaran;Sumanta K. Pal;Neeraj Agarwal;Ulka N. Vaishampayan;Lori A. Wood;Scott D. Ernst;Georg A. Bjarnason;Jennifer J. Knox;Sandy Srinivas;Jae-Lyun Lee;Nils Kroeger;Toni K. Choueiri
Issue Date
2015
Journal Title
Clinical Genitourinary Cancer
ISSN
1558-7673
Citation
Clinical Genitourinary Cancer, Vol.13(2) : e79~e85, 2015
Abstract
BACKGROUND: Sarcomatoid renal cell carcinoma is associated with poor prognosis. Data regarding outcome in the targeted therapy era are lacking. PATIENTS AND METHODS: Clinical, prognostic, and treatment parameters in metastatic renal cell carcinoma patients with and without sarcomatoid histology treated with targeted therapy were retrospectively analyzed. RESULTS: Two thousand two hundred eighty-six patients were identified (sRCC: n = 230 and non-sRCC: n = 2056). sRCC patients had significantly worse IMDC prognostic criteria compared with non-sRCC (11% vs. 19% favorable risk; 49% vs. 57% intermediate risk, and 40% vs. 24% poor risk; P < .0001). Time from original diagnosis to relapse (excluding synchronous metastatic disease) was shorter in the sRCC group (18.8 vs. 42.9 months; P < .0001). There was no significant difference in the incidence of central nervous system metastases (6%-8%) or underlying clear cell histology (87%-88%). More than 93% of patients received VEGF inhibitors as first-line therapy; objective response was less common in sRCC whereas primary refractory disease was more common (21% vs. 26% and 43% vs. 21%; P < .0001, for both). sRCC patients had significantly less use of second- (P = .018) and third-line (P < .0001) systemic therapy. The median progression-free survival (PFS)/overall survival (OS) was 4.5/10.4 months in sRCC patients and 7.8/22.5 months in non-sRCC patients (P < .0001 for both). Sarcomatoid histology was associated with a significantly worse PFS and OS after adjusting for individual IMDC risk factors in multivariable analysis (hazard ratio, 1.5; P < .0001 for both). CONCLUSION: Patients with sRCC have a shorter time to relapse, worse baseline prognostic criteria, and worse clinical outcome with targeted therapy. Additional insight into the biology of sRCC is needed to develop alternative therapeutics.
URI
http://www.sciencedirect.com/science/article/pii/S1558767314002043

http://ir.ymlib.yonsei.ac.kr/handle/22282913/141620
DOI
10.1016/j.clgc.2014.08.011
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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