An interdisciplinary consensus on the management of bone metastases from renal cell carcinoma

Grünwald, Viktor; Eberhardt, Berit; Bex, Axel; Flörcken, Anne; Gauler, Thomas; Derlin, Thorsten; Panzica, Martin; Dürr, Hans Roland; Grötz, K. A.; Giles, Rachel; Falck, Christian von; Graser, Anno; Muacevic, Alexander; Staehler, Michael

doi:10.1038/s41585-018-0034-9

Cited by 65 publications

(51 citation statements)

References 106 publications

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“…The concern for the unique behavior of and limited treatment options for bone metastases from renal cell carcinoma has led to the convening of an interdisciplinary consensus conference on management that was recently published 69. This group reviewed the literature and provided summaries of clinical evidence and then presented their consensus and recommendations, as well as identification of unmet needs.…”

Section: Sites Of Metastatic Disease: Special Consideration Of Bone Amentioning

confidence: 99%

Update on the Biology and Management of Renal Cell Carcinoma

Dutcher

2019

Journal of Investigative Medicine

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Renal cell cancer (RCC) (epithelial carcinoma of the kidney) represents 2%–4% of newly diagnosed adult tumors. Over the past 2 decades, RCC has been better characterized clinically and molecularly. It is a heterogeneous disease, with multiple subtypes, each with characteristic histology, genetics, molecular profiles, and biologic behavior. Tremendous heterogeneity has been identified with many distinct subtypes characterized. There are clinical questions to be addressed at every stage of this disease, and new targets being identified for therapeutic development. The unique characteristics of the clinical presentations of RCC have led to both questions and opportunities for improvement in management. Advances in targeted drug development and understanding of immunologic control of RCC are leading to a number of new clinical trials and regimens for advanced disease, with the goal of achieving long-term disease-free survival, as has been achieved in a proportion of such patients historically. RCC management is a promising area of ongoing clinical investigation.

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Section: Sites Of Metastatic Disease: Special Consideration Of Bone Amentioning

confidence: 99%

Update on the Biology and Management of Renal Cell Carcinoma

Dutcher

2019

Journal of Investigative Medicine

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“…As therapeutic methods have improved, the OS of patients with mRCC has become remarkably prolonged. However, these improved survival durations have been accompanied by a higher incidence of BM …”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of 168 Chinese patients after local surgery for bone metastases arising from advanced renal cell carcinoma

Dong

Wang

Lü

et al. 2020

Cancer

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BACKGROUND:The effectiveness of local surgery for bone metastases (BM) arising from renal cell carcinoma (RCC) remains uncertain. Herein, the authors performed what to the best of their knowledge is the first investigation of the outcomes of Chinese patients with RCC and BM. METHODS: Data were collected for 168 patients with RCC and BM who were treated at Changzheng Hospital in Shanghai, China, between March 2009 and December 2018. All patients underwent local surgery for BM arising from RCC. Overall survival (OS) was defined as the interval between the date of local surgery and death or last follow-up and was estimated using the Kaplan-Meier method. Univariate and multivariable Cox proportional hazards analyses were used to identify significant prognostic factors. RESULTS:The median OS in the study cohort was 43 months (range, 0-113 months). The 1-year, 3-year, and 5-year survival rates after surgery were 77.4%, 55.9%, and 31.8%, respectively. Univariate analyses demonstrated significant survival differences associated with sex (P = .003), the number of preoperative metastatic sites (BM alone or BM with concomitant metastasis; P < .001), and the number of BM (single or multiple; P = .008). OS also did not appear to differ regardless of whether the patients received postsurgical targeted therapy. Multivariable Cox regression demonstrated that the following characteristics were independent predictors of OS: the number of preoperative metastatic sites, International Metastatic Renal Cell Carcinoma Database Consortium risk score, and Memorial Sloan Kettering Cancer Center score. CONCLUSIONS: Careful patient selection for local surgery is of paramount importance. The prognoses of patients in the Memorial Sloan Kettering Cancer Center-based and International Metastatic Renal Cell Carcinoma Database Consortium-based poor-risk groups were much worse than those of the intermediate-risk groups. In current clinical practice, "stratified treatment" can be performed according to these criteria.

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“…Finally, the subgroup of patients who developed bone metastases later during the course of disease was too small to perform meaningful analyses. The optimal integration of local treatment, such as surgery or stereotactic radiotherapy, especially in patients with few metastatic lesions, is a topic of ongoing research (22,23). In principle, such approaches may contribute to bone stability, reduced symptoms and better disease control.…”

Section: Discussionmentioning

confidence: 99%