Survival of metastatic renal cell carcinoma patients continues to improve over time, even in targeted therapy era
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Survival of metastatic renal cell carcinoma patients continues to improve over time, even in targeted therapy era. / Marchioni, Michele; Bandini, Marco; Pompe, Raisa S; Tian, Zhe; Martel, Tristan; Kapoor, Anil; Cindolo, Luca; Berardinelli, Francesco; Briganti, Alberto; Shariat, Shahrokh F; Schips, Luigi; Karakiewicz, Pierre I.
in: INT UROL NEPHROL, Jahrgang 49, Nr. 12, 12.2017, S. 2143-2149.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Survival of metastatic renal cell carcinoma patients continues to improve over time, even in targeted therapy era
AU - Marchioni, Michele
AU - Bandini, Marco
AU - Pompe, Raisa S
AU - Tian, Zhe
AU - Martel, Tristan
AU - Kapoor, Anil
AU - Cindolo, Luca
AU - Berardinelli, Francesco
AU - Briganti, Alberto
AU - Shariat, Shahrokh F
AU - Schips, Luigi
AU - Karakiewicz, Pierre I
PY - 2017/12
Y1 - 2017/12
N2 - OBJECTIVE: To examine the effect of diagnosis year, defined as contemporary (2010-2014), intermediate (2006-2009) and historical (2001-2005) on cancer-specific mortality (CSM) in patients with metastatic renal cell carcinoma (mRCC).METHODS: Within Surveillance, Epidemiology, and End Results registry (2001-2014), we identified patients with mRCC. Cumulative incidence and competing risks regression (CRR) models examined CSM, after accounting for other-cause mortality. Finally, we performed subgroup analyses according to histological subtype: clear-cell mRCC (ccmRCC) versus non-ccmRCC.RESULTS: We identified 15,444 patients with mRCC. Of those, 41.0, 28.7 and 30.3% were diagnosed, respectively, in the contemporary, intermediate and historical years. Of all, 47.1, 5.3 and 47.6% were, respectively, ccmRCC, non-ccmRCC and other mRCC histological variants [sarcomatoid mRCC, cyst-associated mRCC, collecting duct carcinoma and mRCC not otherwise specified (NOS)]. Overall, 24-month CSM rates were, respectively, 61.0, 63.7 and 67.3% in contemporary, intermediate and historical patients. In all patients, multivariable CRR models exhibited higher CSM in intermediate (HR 1.11; p < 0.001) and historical patients (HR 1.24; p < 0.001) than in contemporary patients. Multivariable CRR models focusing on ccmRCC yielded virtually the same results. However, multivariable CRR models focusing on non-ccmRCC showed no CSM differences according to diagnosis year (all p ≥ 0.3).CONCLUSION: The introduction of new therapeutic agents resulted in CSM-free survival improvement over study time. However, this effect exclusively applies to patients with ccmRCC, but not to those with non-ccmRCC. This observation is in agreement with established efficacy of systemic therapies for ccmRCC, but lesser efficacy of these agents for non-ccmRCC.
AB - OBJECTIVE: To examine the effect of diagnosis year, defined as contemporary (2010-2014), intermediate (2006-2009) and historical (2001-2005) on cancer-specific mortality (CSM) in patients with metastatic renal cell carcinoma (mRCC).METHODS: Within Surveillance, Epidemiology, and End Results registry (2001-2014), we identified patients with mRCC. Cumulative incidence and competing risks regression (CRR) models examined CSM, after accounting for other-cause mortality. Finally, we performed subgroup analyses according to histological subtype: clear-cell mRCC (ccmRCC) versus non-ccmRCC.RESULTS: We identified 15,444 patients with mRCC. Of those, 41.0, 28.7 and 30.3% were diagnosed, respectively, in the contemporary, intermediate and historical years. Of all, 47.1, 5.3 and 47.6% were, respectively, ccmRCC, non-ccmRCC and other mRCC histological variants [sarcomatoid mRCC, cyst-associated mRCC, collecting duct carcinoma and mRCC not otherwise specified (NOS)]. Overall, 24-month CSM rates were, respectively, 61.0, 63.7 and 67.3% in contemporary, intermediate and historical patients. In all patients, multivariable CRR models exhibited higher CSM in intermediate (HR 1.11; p < 0.001) and historical patients (HR 1.24; p < 0.001) than in contemporary patients. Multivariable CRR models focusing on ccmRCC yielded virtually the same results. However, multivariable CRR models focusing on non-ccmRCC showed no CSM differences according to diagnosis year (all p ≥ 0.3).CONCLUSION: The introduction of new therapeutic agents resulted in CSM-free survival improvement over study time. However, this effect exclusively applies to patients with ccmRCC, but not to those with non-ccmRCC. This observation is in agreement with established efficacy of systemic therapies for ccmRCC, but lesser efficacy of these agents for non-ccmRCC.
KW - Journal Article
U2 - 10.1007/s11255-017-1703-y
DO - 10.1007/s11255-017-1703-y
M3 - SCORING: Journal article
C2 - 28932952
VL - 49
SP - 2143
EP - 2149
JO - INT UROL NEPHROL
JF - INT UROL NEPHROL
SN - 0301-1623
IS - 12
ER -
