Cited 67 times in
Survival outcome and treatment response of patients with late relapse from renal cell carcinoma in the era of targeted therapy.
DC Field | Value | Language |
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dc.contributor.author | 라선영 | - |
dc.date.accessioned | 2015-12-28T11:05:01Z | - |
dc.date.available | 2015-12-28T11:05:01Z | - |
dc.date.issued | 2014 | - |
dc.identifier.issn | 0302-2838 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/138656 | - |
dc.description.abstract | BACKGROUND: A subset of primarily localized renal cell carcinoma (RCC) patients will experience disease recurrence ≥5 yr after initial nephrectomy. OBJECTIVE: To characterize the clinical outcome of patients with late recurrence beyond 5 yr. DESIGN, SETTING, AND PARTICIPANTS: Patients with metastatic RCC (mRCC) treated with targeted therapy were retrospectively characterized according to time to relapse. Relapse was defined as the diagnosis of recurrent metastatic disease >3 mo after initial curative-intent nephrectomy. Patients with synchronous metastatic disease at presentation were excluded. Patients were classified as early relapsers (ERs) if they recurred within 5 yr; late relapsers (LRs) recurred after 5 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Demographics were compared with the Student t test, the chi-square test, or the Fisher exact test. The survival time was estimated with the Kaplan-Meier method, and associations with survival outcome were assessed with univariable and multivariable Cox regression analyses. RESULTS AND LIMITATIONS: Among 1210 mRCC patients treated with targeted therapy after surgery for localized disease, 897 (74%) relapsed within the first 5 yr and 313 (26%) (range: 5-35 yr) after 5 yr. LRs presented with younger age (p<0.0001), fewer with sarcomatoid features (p<0.0001), more clear cell histology (p=0.001), and lower Fuhrman grade (p<0.0001). Overall objective response rates to targeted therapy were better in LRs versus ERs (31.8% vs 26.5%; p=0.004). LRs had significantly longer progression-free survival (10.7 mo vs 8.5 mo; p=0.005) and overall survival (OS; 34.0 mo vs 27.4 mo; p=0.004). The study is limited by its retrospective design, noncentralized imaging and pathology review, missing information on metastatectomy, and nonstandardized follow-up protocols. CONCLUSIONS: A quarter of patients who eventually developed metastatic disease and were treated with targeted therapy relapsed over 5 yr from initial nephrectomy. LRs have more favorable prognostic features and consequently better treatment response and OS. | - |
dc.description.statementOfResponsibility | open | - |
dc.format.extent | 1086~1092 | - |
dc.relation.isPartOf | EUROPEAN UROLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Age Factors | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Antineoplastic Agents/therapeutic use* | - |
dc.subject.MESH | Carcinoma, Renal Cell/drug therapy* | - |
dc.subject.MESH | Carcinoma, Renal Cell/secondary* | - |
dc.subject.MESH | Carcinoma, Renal Cell/surgery | - |
dc.subject.MESH | Disease-Free Survival | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Kidney Neoplasms/drug therapy* | - |
dc.subject.MESH | Kidney Neoplasms/pathology* | - |
dc.subject.MESH | Kidney Neoplasms/surgery | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Molecular Targeted Therapy | - |
dc.subject.MESH | Neoplasm Grading | - |
dc.subject.MESH | Nephrectomy | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Survival Rate | - |
dc.subject.MESH | TOR Serine-Threonine Kinases/antagonists & inhibitors | - |
dc.subject.MESH | Time Factors | - |
dc.subject.MESH | Vascular Endothelial Growth Factor A/antagonists & inhibitors | - |
dc.title | Survival outcome and treatment response of patients with late relapse from renal cell carcinoma in the era of targeted therapy. | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학) | - |
dc.contributor.googleauthor | Nils Kroeger | - |
dc.contributor.googleauthor | Toni K. Chouei | - |
dc.contributor.googleauthor | Jae Lyn Lee | - |
dc.contributor.googleauthor | Georg A. Bjarnason | - |
dc.contributor.googleauthor | Jennifer J. Knox | - |
dc.contributor.googleauthor | Mary J. MacKenzie | - |
dc.contributor.googleauthor | Lori Wood | - |
dc.contributor.googleauthor | Sandy Srinivas | - |
dc.contributor.googleauthor | Ulka N. Vaishamayan | - |
dc.contributor.googleauthor | Sun Young Rha | - |
dc.contributor.googleauthor | Sumanta K. Pal | - |
dc.contributor.googleauthor | Takeshi Yuasa | - |
dc.contributor.googleauthor | Frede Donskov | - |
dc.contributor.googleauthor | Neeraj Agarwal | - |
dc.contributor.googleauthor | Min Han Tan | - |
dc.contributor.googleauthor | Aristotelis Bamias | - |
dc.contributor.googleauthor | Christian K. Kollmannsberger | - |
dc.contributor.googleauthor | Scott A. North | - |
dc.contributor.googleauthor | Brian I. Rini | - |
dc.contributor.googleauthor | Daniel Y.C. Heng | - |
dc.identifier.doi | 10.1016/j.eururo.2013.07.031 | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A01316 | - |
dc.relation.journalcode | J00854 | - |
dc.identifier.eissn | 1873-7560 | - |
dc.identifier.pmid | 23916693 | - |
dc.identifier.url | http://www.sciencedirect.com/science/article/pii/S030228381300746X | - |
dc.subject.keyword | Late recurrence | - |
dc.subject.keyword | Renal cell carcinoma | - |
dc.subject.keyword | Survival outcome | - |
dc.subject.keyword | Targeted therapies | - |
dc.subject.keyword | Treatment response | - |
dc.contributor.alternativeName | Rha, Sun Young | - |
dc.contributor.affiliatedAuthor | Rha, Sun Young | - |
dc.rights.accessRights | free | - |
dc.citation.volume | 65 | - |
dc.citation.number | 6 | - |
dc.citation.startPage | 1086 | - |
dc.citation.endPage | 1092 | - |
dc.identifier.bibliographicCitation | EUROPEAN UROLOGY, Vol.65(6) : 1086-1092, 2014 | - |
dc.identifier.rimsid | 46115 | - |
dc.type.rims | ART | - |
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