Is It Possible to Improve Prognostic Classification in Patients Affected by Metastatic Renal Cell Carcinoma With an Intermediate or Poor Prognosis?

被引：29

作者：

Iacovelli, Roberto ^{[1
]}

De Giorgi, Ugo ^{[2
]}

Galli, Luca ^{[3
,4
]}

Zucali, Paolo ^{[5
]}

Nole, Franco ^{[6
]}

Sabbatini, Roberto ^{[7
,8
]}

Fraccon, Anna Paola ^{[9
]}

Basso, Umberto ^{[10
]}

Mosca, Alessandra ^{[11
]}

Atzori, Francesco ^{[12
]}

Santini, Daniele ^{[13
]}

Facchini, Gaetano ^{[14
]}

Fornarini, Giuseppe ^{[15
]}

Pasini, Felice ^{[9
]}

Masini, Cristina ^{[16
]}

Massari, Francesco ^{[17
]}

Buti, Sebastiano ^{[18
]}

Sava, Teodoro ^{[19
]}

Sacco, Cosimo ^{[20
]}

Ricotta, Riccardo ^{[21
]}

Sperduti, Isabella ^{[22
]}

Tortora, Giampaolo ^{[1
]}

Porta, Camillo ^{[23
]}

机构：

[1] Azienda Osped Univ Integrata, Dept Med Oncol, Verona, Italy

[2] IRCCS Ist Sci Romagnolo Studio & Cura Tumori, Dept Med Oncol, Meldola, Italy

[3] Azienda Osped Univ Pisana, Dept Med Oncol 2, Pisa, Italy

[4] Ist Toscano Tumori, Pisa, Italy

[5] Humanitas Canc Ctr, Humanitas Clin & Res Ctr, Rozzano, Italy

[6] European Inst Oncol, Div Urogenital & Head & Neck Tumours, Dept Med Oncol, Milan, Italy

[7] Univ Modena & Reggio Emilia, Dept Oncol Haematol & Radiotherapy, Modena, Italy

[8] Univ Modena & Reggio Emilia, Dept Oncol Haematol & Radiotherapy, Reggio Emilia, Italy

[9] Casa Cura Pederzoli, Med Oncol Unit, Verona, Italy

[10] Ist Oncol Veneto IRCCS, Dept Clin & Expt Oncol, Padua, Italy

[11] Maggiore della Carita Univ Hosp, Dept Med Oncol, Novara, Italy

[12] Azienda Osped Univ, Dept Med Oncol, Cagliari, Italy

[13] Campus Biomed Univ Rome, Dept Med Oncol, Rome, Italy

[14] IRCCS Fdn G Pascale, Ist Nazl Tumori, Dept Urogynaecol Oncol, Div Med Oncol, Naples, Italy

[15] IRCCS Azienda Osped Univ San Martino, Dept Med Oncol, Ist Nazl Ric Canc, Genoa, Italy

[16] IRCCS Arcispedale Santa Maria Nuova, Dept Med Oncol, Reggio Emilia, Italy

[17] St Orsola Malpighi Hosp, Div Oncol, Bologna, Italy

[18] Univ Hosp, Dept Med Oncol, Parma, Italy

[19] Camposampiero Cittadella, Dept Oncol, Padua, Italy

[20] Santa Maria Misericordia Hosp, Med Oncol Unit, Udine, Italy

[21] Grande Osped Metropolitano Niguarda, Niguarda Canc Ctr, Milan, Italy

[22] Regina Elena Inst Canc Res, Biostat Unit, Rome, Italy

[23] IRCCS San Matteo Univ Hosp Fdn, Dept Med Oncol, Pavia, Italy

来源：

CLINICAL GENITOURINARY CANCER | 2018年 / 16卷 / 05期

关键词：

mRCC; Intermediate risk; Overall survival; Poor risk; Sunitinib; TARGETED THERAPY; SUNITINIB; SURVIVAL; EFFICACY; TRIAL;

D O I：

10.1016/j.clgc.2018.04.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We analyzed the prognosis of patients affected by metastatic renal cell carcinoma (mRCC) with an intermediate or a poor prognosis using the International mRCC Database Consortium criteria and treated with first-line sunitinib. We found that within the intermediate class, as well as within the poor prognosis group, the expected survival will be significantly different according to the presence of 1 or 2 prognostic factors. Background: The International mRCC (metastatic renal cell carcinoma) Database Consortium (IMDC) is the standard classification for mRCC. We aimed to evaluate the outcomes of a large cohort of patients with an intermediate or a poor prognosis treated with sunitinib using a different cutoff point for IMDC to improve the classification. Patients and Methods: Patients with an intermediate or a poor prognosis according to the IMDC criteria and treated with sunitinib were included in the present study. A new cutoff point was used to categorize the patients. The new score was validated in an independent cohort of patients. Results: A total of 457 patients were included in the present study. Significant differences in overall survival (OS) were highlighted regarding the number of prognostic factors. Three categories were identified according to the presence of 1 (ie, favorable-intermediate group), 2 (ie, real-intermediate group), and > 2 (ie, poor group) factors. The corresponding median OS periods were 32.9, 20.0, and 8.9 months, with significant differences among the groups. The validation cohort included 389 patients. The median OS period for the favorable-intermediate group, real-intermediate group, and poor group was 34.3, 19.4, and 9.0 months, respectively, with confirmed significant differences among the groups. Conclusion: Our analysis revealed significant differences among patients with an intermediate prognosis using the IMDC prognostic factors. Further investigations to optimize the use of available and upcoming therapies are required. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：355 / +

页数：6

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