Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy
Standard
Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy. / Tilki, Derya; Hu, Brian; Nguyen, Hao G; Dall'Era, Marc A; Bertini, Roberto; Carballido, Joaquín A; Chandrasekar, Thenappan; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; Gonzalez, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C; Koppie, Theresa M; Linares, Estefania; Lorentz, C Adam; Mandel, Philipp; Martinez-Salamanca, Juan I; Master, Viraj A; Matloob, Rayan; McKiernan, James M; Mlynarczyk, Carrie M; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S; Ramaswamy, Krishna; Rodriguez Faba, Oscar; Russo, Paul; Shariat, Shahrokh F; Spahn, Martin; Terrone, Carlo; Thieu, William; Vergho, Daniel; Wallen, Eric M; Xylinas, Evanguelos; Zigeuner, Richard; Libertino, John A; Evans, Christopher P.
in: J UROLOGY, Jahrgang 193, Nr. 2, 02.2015, S. 436-42.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy
AU - Tilki, Derya
AU - Hu, Brian
AU - Nguyen, Hao G
AU - Dall'Era, Marc A
AU - Bertini, Roberto
AU - Carballido, Joaquín A
AU - Chandrasekar, Thenappan
AU - Chromecki, Thomas
AU - Ciancio, Gaetano
AU - Daneshmand, Siamak
AU - Gontero, Paolo
AU - Gonzalez, Javier
AU - Haferkamp, Axel
AU - Hohenfellner, Markus
AU - Huang, William C
AU - Koppie, Theresa M
AU - Linares, Estefania
AU - Lorentz, C Adam
AU - Mandel, Philipp
AU - Martinez-Salamanca, Juan I
AU - Master, Viraj A
AU - Matloob, Rayan
AU - McKiernan, James M
AU - Mlynarczyk, Carrie M
AU - Montorsi, Francesco
AU - Novara, Giacomo
AU - Pahernik, Sascha
AU - Palou, Juan
AU - Pruthi, Raj S
AU - Ramaswamy, Krishna
AU - Rodriguez Faba, Oscar
AU - Russo, Paul
AU - Shariat, Shahrokh F
AU - Spahn, Martin
AU - Terrone, Carlo
AU - Thieu, William
AU - Vergho, Daniel
AU - Wallen, Eric M
AU - Xylinas, Evanguelos
AU - Zigeuner, Richard
AU - Libertino, John A
AU - Evans, Christopher P
N1 - Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2015/2
Y1 - 2015/2
N2 - PURPOSE: Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival.MATERIALS AND METHODS: The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates.RESULTS: Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival.CONCLUSIONS: In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.
AB - PURPOSE: Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival.MATERIALS AND METHODS: The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates.RESULTS: Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival.CONCLUSIONS: In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Carcinoma, Renal Cell
KW - Humans
KW - Kidney Neoplasms
KW - Middle Aged
KW - Neoplastic Cells, Circulating
KW - Nephrectomy
KW - Survival Rate
KW - Thrombectomy
KW - Young Adult
KW - Journal Article
U2 - 10.1016/j.juro.2014.07.087
DO - 10.1016/j.juro.2014.07.087
M3 - SCORING: Journal article
C2 - 25063493
VL - 193
SP - 436
EP - 442
JO - J UROLOGY
JF - J UROLOGY
SN - 0022-5347
IS - 2
ER -