Overall survival after stereotactic radiotherapy or surgical metastasectomy in oligometastatic renal cell carcinoma patients treated at two Swedish centres 2005–2014

Stenman, Maria; Sinclair, Georges; Paavola, Paulina; Wersäll, Peter; Harmenberg, Ulrika; Lindskog, Magnus

doi:10.1016/j.radonc.2018.04.028

Cited by 60 publications

(51 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We limited this analysis to patients treated with first-line docetaxel rather than a variety of different approved options in order to eliminate bias arising from differences in first-line systemic treatment. As recently discussed by different groups, aggressive local treatment of oligometastatic cancer is expected to improve survival (2)(3)(4)18). Even in the absence of metastasis-directed local treatment, we found long-term survivors in the group with normal hemoglobin (and also LDH).…”

Section: Discussionsupporting

confidence: 65%

Contribution of Serum Biomarkers to Prognostic Assessment in Patients With Oligometastatic Prostate Cancer

Nieder

Dalhaug

Pawinski

2019

In Vivo

View full text Add to dashboard Cite

Background/Aim: The aim of this study was to analyze the prognostic impact of biomarkers, such as serum lactate dehydrogenase (LDH), in patients with oligometastatic castration-resistant prostate cancer, arbitrarily defined as a maximum of five metastatic lesions. Patients and Methods: This was a retrospective single-institution analysis. Overall 34 patients were included, all of whom received first-line docetaxel without ablative local treatment. Results: Twelve patients (35%) had elevated LDH (≥255 U/l). Their median survival was significantly shorter than that of patients with normal LDH. Due to an interaction with other biomarkers, multivariate Cox regression analysis was performed. The latter showed that serum hemoglobin was the only significant predictor of survival. Conclusion: Correct diagnosis of oligometastatic disease is not trivial, because all radiological modalities are limited by certain thresholds for detection of small metastases. Serum biomarkers may reflect the total burden of malignant disease. However, this relatively small study did not clearly demonstrate that elevation of LDH may be useful for clinical decision-making, e.g. in terms of adding local treatment for all sites of metastatic spread.

show abstract

Section: Discussionsupporting

confidence: 65%

Contribution of Serum Biomarkers to Prognostic Assessment in Patients With Oligometastatic Prostate Cancer

Nieder

Dalhaug

Pawinski

2019

In Vivo

View full text Add to dashboard Cite

show abstract

“…rough a retrospective analysis involving 117 patients with mRCC, our group reported the crucial impact of local metastatic therapy (including brain stereotactic radiation) on overall survival. [32] Similar conclusions can be found in the medical literature. [5,22,32] In the context of large brain metastases, safe microsurgical resection followed by radiation to the surgical cavity by LINAC-based instruments or gamma knife remains the best therapeutic option in many centers; [2,6,8,14,22,34] however, as in our patient, this approach is often precluded by the presence of complex variables such as tumor volume, tumor growth kinetics, patterns of infiltration, degree of regional neurofunction, underlying meta-/synchronous metastatic activity, RPA-surrogate factors/comorbidity, and intrinsic stress responses conditioning tumor radioresistance.…”

Section: Introductionsupporting

confidence: 79%

Adaptive radiosurgery based on two simultaneous dose prescriptions in the management of large renal cell carcinoma brain metastases in critical areas: Towards customization

Sinclair

Stenman

Benmakhlouf

et al. 2020

Surgical Neurology International

Self Cite

View full text Add to dashboard Cite

Background: The long-term benefits of local therapy in metastatic renal cell carcinoma (mRCC) have been widely documented. In this context, single fraction gamma knife radiosurgery (SF-GKRS) is routinely used in the management of brain metastases. However, SF-GKRS is not always feasible due to volumetric and regional constraints. We intend to illustrate how a dose-volume adaptive hypofractionated GKRS technique based on two concurrent dose prescriptions termed rapid rescue radiosurgery (RRR) can be utilized in this particular scenario. Case Description: A 56-year-old man presented with left-sided hemiparesis; the imaging showed a 13.1 cc brain metastasis in the right central sulcus (Met 1). Further investigation confirmed the histology to be a metastatic clear cell RCC. Met 1 was treated with upfront RRR. Follow-up magnetic resonance imaging (MRI) at 10 months showed further volume regression of Met 1; however, concurrently, a new 17.3 cc lesion was reported in the boundaries of the left frontotemporal region (Met 2) as well as a small metastasis (<1 cc) in the left temporal lobe (Met 3). Met 2 and Met 3 underwent RRR and SF-GKRS, respectively. Results: Gradual and sustained tumor ablation of Met 1 and Met 2 was demonstrated on a 20 months long follow- up. The patient succumbed to extracranial disease 21 months after the treatment of Met 1 without evidence of neurological impairment post-RRR. Conclusion: Despite poor prognosis and precluding clinical factors (failing systemic treatment, eloquent location, and radioresistant histology), RRR provided optimal tumor ablation and salvage of neurofunction with limited toxicity throughout follow-up.

show abstract

“…Oligometastatic RCC can be treated radically as a localised disease [2]. Surgery or stereotactic radiosurgery of metastatic sites can be offered aiming to prolong time-to-treatment and OS [2,3]. Usually, these treatments are offered to a selected population with good performance status and fit enough to undergo surgical interventions with an underlying active cancer.…”

Section: Introductionmentioning

confidence: 99%

Complete metastasectomy in renal cell carcinoma: a propensity-score matched by the International Metastatic RCC Database Consortium prognostic model

Fares

Araújo

Calsavara

et al. 2019

ecancer

View full text Add to dashboard Cite

Introduction: We evaluated overall survival (OS) benefit of complete metastasectomy (CM) in metastatic renal cell carcinoma (mRCC) using a propensity score-matched (PSM) analysis to balance groups by age, gender and by the International Metastatic RCC Database Consortium prognostic model (IMDC). Methods: We included patients (pts) treated at the AC Camargo Cancer Center between 2007 and 2016. Pairs were matched by age, gender and IMDC. Kaplan-Meier survival estimates and Cox proportional hazard models were used to evaluate OS on CM and no-CM group. Results: We found 116 pts with clear cell mRCC. After PSM, the number was reduced to 74 (37 CM, 37 no-CM). The median OS for CM and no-CM was 98.3 months and 40.5 months, respectively (hazard ratio 0.24 95%CI 0.11-0.53 p < 0.001). The OS benefit of CM was confirmed on favourable and intermediate IMDC but was absent on poor IMDC. The CM group received less systemic therapy than the no-CM group. Ten pts in the CM group still have no evidence of disease (NED). Conclusion: After matching for age, gender and IMDC, we found CM impacts on OS and also diminishes the need for systemic treatment. Survival benefit was confirmed for favourable/intermediate IMDC but not for the poor IMDC prognostic model. Further studies correlating IMDC and metastasectomy are needed to guide clinical decision-making.

show abstract

Overall survival after stereotactic radiotherapy or surgical metastasectomy in oligometastatic renal cell carcinoma patients treated at two Swedish centres 2005–2014

Cited by 60 publications

References 29 publications

Contribution of Serum Biomarkers to Prognostic Assessment in Patients With Oligometastatic Prostate Cancer

Contribution of Serum Biomarkers to Prognostic Assessment in Patients With Oligometastatic Prostate Cancer

Adaptive radiosurgery based on two simultaneous dose prescriptions in the management of large renal cell carcinoma brain metastases in critical areas: Towards customization

Complete metastasectomy in renal cell carcinoma: a propensity-score matched by the International Metastatic RCC Database Consortium prognostic model

Contact Info

Product

Resources

About