The impact of sex and age on distribution of metastases in patients with renal cell carcinoma

Rosiello, Giuseppe; Pecoraro, Angela; Deuker, Marina; Stolzenbach, Lara Franziska; Martin, Thomas; Tian, Zhe; Larcher, Alessandro; Capitanio, Umberto; Montorsi, Francesco; Shariat, Shahrokh F.; Kapoor, Anil; Saad, Fred; Briganti, Alberto; Karakiewicz, Pierre I.

doi:10.1007/s10147-021-01874-3

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Similarly, younger age at diagnosis was a well-acknowledged risk factor for several solid tumors ( 28 ). Previous studies repeatedly demonstrated that younger patients tend to show a more aggressive disease course ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

A population-based investigation: How to identify high-risk T1-2N0 esophageal cancer patients?

Peng

Chen

et al. 2023

Front. Surg.

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PurposeNewly diagnosed T1-2N0 esophageal cancer (EC) is generally deemed as early local disease, with distant metastases (DM) easily overlooked. This retrospective study aimed to describe the metastatic patterns, identify risk factors and established a risk prediction model for DM in T1-2N0 EC patients.MethodsA total of 4623 T1-2N0 EC patients were identified in the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2018. Multivariable logistic regression was used to identify risk factors for DM. A nomogram was developed for presentation of the final model.ResultsOf 4623 T1-2N0 patients, 4062 (87.9%) had M0 disease and 561 (12.1%) had M1 disease. The most common metastatic site was liver (n = 156, 47.3%), followed by lung (n = 89, 27.0%), bone (n = 70, 21.2%) and brain (n = 15, 4.5%). Variables independently associated with DM included age at diagnosis, gender, tumor grade, primary site, tumor size and T stage. A nomogram based on the variables had a good predictive accuracy (area under the curve: 0.750). Independent risk factors for bone metastases (BoM), brain metastases (BrM), liver metastases (LiM) and lung metastases (LuM) were identified, respectively.ConclusionsWe identified independent predictive factors for DM, as well as for BoM, BrM, LiM and LuM. Above all, a practical and convenient nomogram with a great accuracy to predict DM probability for T1-2N0 EC patients was established.

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Section: Discussionmentioning

confidence: 99%

A population-based investigation: How to identify high-risk T1-2N0 esophageal cancer patients?

Peng

Chen

et al. 2023

Front. Surg.

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“…In literature, only a small cohort study and a case report are available on PM from urinary tract and kidney cancer and they did not report on incidence numbers [ 23 , 24 ]. In this study, PM from urinary tract and kidney cancer were quite relevant as they ranked as the second and fourth most common extraperitoneal cancer causes of PM respectively.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Metastases from Extraperitoneal Primary Tumors: Incidence, Treatment, and Survival from a Nationwide Database

Rijken

Galanos

Burger

et al. 2022

Indian J Surg Oncol

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The objective of this study was to assess the incidence, treatment, and survival of patients with synchronous peritoneal metastases (PM) from extraperitoneal primary tumors. A cohort was selected from the Netherlands Cancer Registry (NCR), in which all patients diagnosed with PM in 2017 and 2018 were screened for eligibility. The five most common primary extraperitoneal origins of PM were included for further analyses: lung, breast, urinary tract, and kidney cancer and malignant melanoma. Survival was investigated using log-rank test between different primary tumor locations. In total, 480 patients were diagnosed with synchronous PM from extraperitoneal origins. The proportion of patients with PM per extraperitoneal origin ranged between 0.1 and 1.1%, with the highest proportion in lung cancer patients. Of all patients, 234 (49%) received tumor-directed treatment and 246 (51%) received no tumor-directed treatment. Survival in patients with PM from lung, breast, urinary tract, and kidney cancer and malignant melanoma was 1.6 months, 15.7 months, 5.4 months, 3.4 months, and 2.1 months, respectively (p < 0.001). In this study, a small, although significant number of patients with extraperitoneal cancer developed PM. The reported survival in patients with PM ranged between 1.6 and 15.7 months. Only half of the patients with PM received tumor-directed treatment and survival in patients without tumor-directed treatment was only 1.2 months. These findings are stressing the need to explore new diagnostic tools that may enable earlier diagnosis of PM and may potentially lead to a more effective treatment.

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“…For example, female sex is established as a prognosticator of worse survival in patients with muscle-invasive bladder UC [ 7 ]. In mRCC, similarly, sex-related discrepancies in the distribution of metastases exist [ 8 ]. These differences between men and woman suggest that biological, genetic, and social differences between sexes play an important role in the biology and natural history (i.e., response to therapy) of the underlying disease.…”

Section: Introductionmentioning

confidence: 99%

Impact of sex on the efficacy of immune checkpoint inhibitors in kidney and urothelial cancers: a systematic review and meta-analysis

et al. 2023

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Purpose To analyze and summarize the efficacy of immune checkpoint inhibitor (ICI) alone or in combination therapy for renal cell carcinoma (RCC) and urothelial carcinoma (UC) stratified by sex. Methods Three databases were queried in October 2022 for randomized controlled trials (RCTs) analyzing RCC and UC patients treated with ICIs. We analyzed the association between sex and the efficacy of ICIs in RCC and UC patients across several clinical settings. The outcomes of interest were overall survival (OS) and progression-free survival for the metastatic setting and disease-free survival (DFS) for the adjuvant setting. Results Overall, 16 RCTs were included for meta-analyses and network meta-analyses. In the first-line treatment of metastatic RCC (mRCC) and UC (mUC) patients, ICI-based combination therapies significantly improved OS compared to the current standard of care, regardless of sex. Adjuvant ICI monotherapy reduced the risk of disease recurrence in female patients with locally advanced RCC (pooled hazard ratio [HR]: 0.71, 95% confidence interval [CI] 0.55–0.93) but not in male patients, and, conversely, in male patients with muscle-invasive UC (pooled HR: 0.80, 95%CI 0.68–0.94) but not in female patients. Treatment ranking analyses in the first-line treatment of mRCC and mUC showed different results between sexes. Of note, regarding adjuvant treatment for RCC, pembrolizumab (99%) had the highest likelihood of improved DFS in males, whereas atezolizumab (84%) in females. Conclusions OS benefit of first-line ICI-based combination therapy was seen in mRCC and mUC patients regardless of sex. Sex-based recommendations for ICI-based regimens according to the clinical setting may help guide clinical decision-making.

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The impact of sex and age on distribution of metastases in patients with renal cell carcinoma

Cited by 4 publications

References 22 publications

A population-based investigation: How to identify high-risk T1-2N0 esophageal cancer patients?

A population-based investigation: How to identify high-risk T1-2N0 esophageal cancer patients?

Peritoneal Metastases from Extraperitoneal Primary Tumors: Incidence, Treatment, and Survival from a Nationwide Database

Impact of sex on the efficacy of immune checkpoint inhibitors in kidney and urothelial cancers: a systematic review and meta-analysis

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