A retrospective comparative study of progression-free survival and overall survival between metachronous and synchronous metastatic renal cell carcinoma in intermediate- or poor-risk patients treated with VEGF-targeted therapy

Abstract

IntroductionThe aim of this study was to compare progression-free survival (PFS) and overall survival (OS) between metachronous and synchronous metastatic renal cell carcinomas treated with VEGF-targeted therapy.MethodsBetween 2005 and 2014, 93 (78.8%) intermediate- and 25 (21.2%) poor-Heng-risk patients, including 32 (27.1%) patients with metachronous and 86 (72.9%) patients with synchronous renal cell carcinoma, were enrolled retrospectively. PFS and OS values were compared according to the number of risk factors and treatment-free interval using the Kaplan-Meier method and log-rank test. The prognostic risk factors were also evaluated using a Cox proportional hazard model, with a p-value < 0.05 indicating statistical significance.ResultsDuring a median 5.0-month treatment and 59.3-month follow-up, analysis of the PFS/OS of SM (5.2/9.6 months) and MM (9.6/20.1 months) yielded a significant difference in OS (p = 0.010). However, there was no significant difference when Heng risk groups and treatment-free interval were considered (p > 0.05). There was a significant difference in PFS (hazard ratio: 1.81) and OS (hazard ratio: 2.19) with increasing number of Heng risk factors among patients with synchronous renal cell carcinoma and a treatment-free interval <1 year. Metastatic type, anemia, and neutrophilia were significant predictive factors for OS in multivariable analysis (p < 0.05).ConclusionThe metastatic type of renal cell carcinoma (synchronous or metachronous) significantly affects survival; metachronous type is associated with more favorable outcomes than synchronous type. However, after stratification according to Heng risk factors and treatment-free interval, the differences in survival between metachronous and synchronous type were insignificant.

Survival and clinical prognostic factors in metastatic non‐clear cell renal cell carcinoma treated with targeted therapy: A multi‐institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

“…Generally, metachronous metastasis (MM) is considered to have a better prognosis than synchronous metastasis (SM) in the field of metastatic RCC . It can be explained by the presence or absence of primary tumors following nephrectomy, or the distinct phenotypes with different ontogenetic activities between the two groups.…”

“…Generally, metachronous metastasis (MM) is considered to have a better prognosis than synchronous metastasis (SM) in the field of metastatic RCC. 23,24 It can be explained by the presence or absence of primary tumors following nephrectomy, or the distinct phenotypes with different ontogenetic activities between the two groups. Kim et al 24 reported that MM is associated with more favorable survival outcomes than SM in patients with metastatic RCC treated with VEGF-TKIs (OS, 20.1 vs 9.6 months, P = 0.010).…”

“…It can be explained by the presence or absence of primary tumors following nephrectomy, or the distinct phenotypes with different ontogenetic activities between the two groups. Kim et al reported that MM is associated with more favorable survival outcomes than SM in patients with metastatic RCC treated with VEGF‐TKIs (OS, 20.1 vs 9.6 months, P = 0.010). In the current study, we also found that that MM had significantly better survival outcomes than SM in Kaplan‐Meier survival analysis in our mNCCRCC cohort (Figure ).…”

Survival prognoses of Heng intermediate-risk patients with metastatic renal cell carcinoma treated with immunotherapy or targeted therapy: A real-world, single-center retrospective study

“…In a study by Tanaka et al [8] of 245 patients with mRCC, approximately one-quarter of the patients were reclassified into different risk groups of the IMDC model after TT administration in the first-line and second-line settings; the [19]. TFI with a 1-year cut-off came from the time from diagnosis to treatment from the Heng risk criteria [5], which is a well-known prognostic risk factor for mRCC [20][21][22][23]. It indirectly depicted the growth rate and aggressiveness of the tumor.…”

Prognostic Significance of Systemic Inflammatory Response in Patients with Synchronous and Metachronous Metastatic Renal Cell Carcinoma Receiving First-Line Tyrosine Kinase Inhibitors

“…First, the prognosis of metachronous tumors are better than that of synchronous tumors. 15 Second, Zheng et al 26 showed different mutational patterns between synchronous and metachronous liver metastases of colorectal cancer. Third, a systematic review of colorectal cancer studies identified significant differences in expression of molecular markers between synchronous and metachronous metastases.…”