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Inherent characteristics of metachronous metastatic renal cell carcinoma in the era of targeted agents

Authors
 Jang Hee Han  ;  Seung Hwan Lee  ;  Won Sik Ham  ;  Woong Kyu Han  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Sung Joon Hong  ;  Young Eun Yoon 
Citation
 Oncotarget, Vol.8(45) : 78825-78837, 2017 
Journal Title
 Oncotarget 
Issue Date
2017
Keywords
metastasis ; prognosis ; renal cell carcinoma ; survival ; targeted therapy
Abstract
Background: To assess the prognostic and predictive factors of time to treatment failure (TTF) and overall survival (OS), respectively, in patients with metachronous metastatic renal cell carcinoma (mRCC) who were treated with targeted agents. Materials and Methods: We retrospectively reviewed metachronous mRCC patients, defined as individuals diagnosed with metastatic disease >3 months after initial nephrectomy, treated at an institute since 2005. Cox proportional hazard regression analysis was performed to discover the most determinant variables associated with TTF and OS. Results: Sarcomatoid features, absence of metastasectomy, multiple site metastasis, time to metastasis <1.5 year, and increased corrected calcium were independent prognostic factors of OS. The low risk group (0-1 risk factors) did not reach the median OS, whereas the OS for the intermediate (2 risk factors) and high risk groups (3-5 risk factors) were 58.6 and 23.6 months, respectively (p<0.001). When a death event was considered the dependent factor, the area under the receiver operating characteristic curve was significantly higher than in the existing International mRCC Database Consortium (IMDC; p=0.010) and Memorial Sloan Kettering Cancer Center (MSKCC; p=0.010) risk criteria models. Conclusion: Initial tumor size or T stage did not affect TTF or OS. Patients who could not undergo metastasectomy and rapidly developed multiple metastases with higher corrected calcium and initial tumors with sarcomatoid features were less likely to benefit from targeted therapy; thus, the new agents under development or clinical trials could be more helpful than the use of standard targeted agents.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161448
DOI
10.18632/oncotarget.20230
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
나군호(Rha, Koon Ho) ; 윤영은(Yoon, Young Eun) ; 이승환(Lee, Seung Hwan) ; 최영득(Choi, Young Deuk) ; 한웅규(Han, Woong Kyu) ; 함원식(Ham, Won Sik) ; 홍성준(Hong, Sung Joon)
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