Survival and Impact of Clinical Prognostic Factors in Surgically Treated Metastatic Renal Cell Carcinoma

Tosco, Lorenzo; Poppel, Hendrik Van; Frea, Bruno; Gregoraci, Giorgia; Joniau, Steven

doi:10.1016/j.eururo.2012.09.037

Cited by 94 publications

(44 citation statements)

References 28 publications

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“…Oligometastases refers to a cancer disease state between local-regional disease and widespread metastatic disease, in which the number of metastatic tumours is truly limited in number and location [34]. This is highly relevant for metastatic RCC patients, as surgical resection of oligometastatic disease is already an established and accepted treatment option [37,38]. There are now multiple published reviews describing the existing literature and rationale [19,35,36 & ].…”

Section: Key Pointsmentioning

confidence: 99%

The emerging roles of stereotactic ablative radiotherapy for metastatic renal cell carcinoma

Cheung

Thibault²,

Bjarnason³

2014

Current Opinion in Supportive &Amp; Palliative Care

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Section: Key Pointsmentioning

confidence: 99%

The emerging roles of stereotactic ablative radiotherapy for metastatic renal cell carcinoma

Cheung

Thibault²,

Bjarnason³

2014

Current Opinion in Supportive &Amp; Palliative Care

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“…3 Approximately one third of patients with RCC present with metastases at the time of first diagnosis but an additional 20-40% of patients with initially localized disease develop meta stases. 4,5 In more than 90% of cases, tumours show epithelial features and are referred to as RCC. RCC is a hetero geneous disorder, histopathologically subdivided into clear cell RCC (75% of cases), papillary RCC (10% of cases), chromo phobe RCC (5% of cases) and collecting duct carcinoma (<1% of cases).…”

Section: Renal Cell Carcinomamentioning

confidence: 99%

Renal cancer in von Hippel–Lindau disease and related syndromes

Bausch

Jilg²,

Gläsker³

et al. 2013

Nat Rev Nephrol

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Sporadic and hereditary forms of renal cell carcinoma (RCC), von Hippel-Lindau (VHL) disease and the familial paraganglioma syndromes are closely related in terms of their clinical, molecular, and genetic aspects. Most RCCs occur sporadically and the heritable fraction of RCC is estimated to be just 2-4%. An understanding of the molecular genetic basis, the disease-specific and gene-specific biology and the clinical characteristics of these cancer syndromes is of utmost importance for effective genetic diagnosis and appropriate treatment. In addition, such insight will improve our understanding of sporadic RCCs. To date, 10 different heritable RCC syndromes have been described. VHL syndrome is the oldest known hereditary RCC syndrome. Similar to VHL disease, phaeochromocytoma is a major manifestation of the paraganglioma syndromes types 1, 3 and 4 in which RCCs have been reported. These syndromes are therefore regarded as VHL-related disorders and are included in this Review. Multifocal tumours, bilateral occurrence, a young age at diagnosis and/or family history are clinical red flags suggestive of hereditary disease and should trigger referral for genetic and molecular analysis. The identification of an underlying genetic alteration enables gene-specific risk assessment and opens up the possibility of a tailored follow-up strategy and specific surveillance protocols as the basis of effective preventive medicine. The important goals of preventive medicine are to increase the life expectancy of affected patients and to improve their quality of life. The study of seemingly rare hereditary syndromes and their susceptibility genes has consistently revealed clues regarding the aetiology and pathogenesis of these diseases, and can aid diagnosis and the development of therapeutics for patients affected by much more common sporadic counterparts.

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“…However, the sample size was relatively small, and the metastases were exclusively in the lung [21]. Tosco et al performed a multicenter retrospective analysis of 109 patients and identified four independent adverse factors on prognosis: T stage of the primary tumor ≥3, Fuhrman grade ≥3, disease-free interval ≤12 months, and multiorgan metastases [22]. The data in our study were in line with 7 previous reports and also indicated that T stage ≥ 3 (HR = 1.88, = 0.015), disease-free interval ≤12 months (HR = 2.34, = 0.003), and multiorgan involvement (HR = 2.00, = 0.011) were associated with poor OS.…”

Section: Discussionmentioning

confidence: 99%

Splenosis Mimicking Recurrence of Renal Cell Carcinoma after Radical Nephrectomy: A Case Report

Kim

Hwang

Lee

et al. 2016

Korean J Urol Oncol

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Objective. To investigate the efficacy of surgery in the treatment of metastatic renal cell carcinoma (mRCC) and to identify prognostic factors. Methods. A single center retrospective study of 96 patients with mRCC from December 2004 to August 2013. Results. The median follow-up time was 45 months. Thirty-one (32.3%) of the patients received complete resection of metastatic sites, 11 (11.5%) of the patients underwent incomplete resection of metastatic sites, and 54 (56.3%) of the patients received no surgery. In the univariate Kaplan-Meier analysis, the median overall survival times of the three groups were 52 months, 16 months, and 22 months, respectively ( < 0.001). The difference in the overall survival time was statistically significant between complete resection and no surgery groups (HR = 0.43, = 0.009), while there was no significant difference between the incomplete metastasectomy and no surgery groups (HR = 1.80, = 0.102). According to the multivariate Cox regression analysis, complete metastasectomy (HR = 0.49, = 0.033), T stage > 3 (HR = 1.88, = 0.015), disease free interval <12 months (HR = 2.34, = 0.003), and multiorgan involvement (HR = 2.00, = 0.011) were significant prognostic factors. Conclusion. In the era of targeted therapy, complete metastasectomy can improve overall survival. Complete metastasectomy, T stage > 3, disease free interval <12 months, and multiorgan involvement are independent prognostic factors.

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Survival and Impact of Clinical Prognostic Factors in Surgically Treated Metastatic Renal Cell Carcinoma

Cited by 94 publications

References 28 publications

The emerging roles of stereotactic ablative radiotherapy for metastatic renal cell carcinoma

The emerging roles of stereotactic ablative radiotherapy for metastatic renal cell carcinoma

Renal cancer in von Hippel–Lindau disease and related syndromes

Splenosis Mimicking Recurrence of Renal Cell Carcinoma after Radical Nephrectomy: A Case Report

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