Статья

Improved Survival in Contemporary Community-Based Patients With Metastatic Clear-Cell Renal Cell Carcinoma Undergoing Active Treatment

Reha‐Baris IncesuCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaSimone MorraCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaLukas ScheipnerCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaAndrea BaudoCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaLetizia Maria Ippolita JannelloCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaMario de AngelisCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaCarolin SiechCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaAnis AssadCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaZhe TianCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaFred SaadCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaShahrokh F. ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AustriaFelix K.‐H. ChunDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, GermanyAlberto BrigantiUnit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Laboratory, IRCCS San Raffaele Scientific Institute, Milan, ItalyOttavio De CobelliDepartment of Urology, IEO European Institute of Oncology, IRCCS, Milan, ItalyLuca CarmignaniDepartment of Urology, IRCCS Ospedale Galeazzi - Sant’Ambrogio, Milan, ItalySascha AhyaiDepartment of Urology, Medical University of Graz, Graz, AustriaNicola LongoDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, ItalyDerya TilkiDepartment of Urology, Koc University Hospital, Istanbul, TurkeyMarkus GraefenMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, GermanyPierre I. KarakiewiczCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

2024en

ABI

Аннотация

BACKGROUND: We hypothesized that the evolving treatment paradigms recommended based on phase III trials may have translated into improved overall survival (OS) in contemporary community-based patients with clear-cell metastatic renal cell carcinoma (ccmRCC) undergoing active treatment. PATIENTS AND METHODS: Within the SEER database, contemporary (2017-2020) and historical (2010-2016) patients with ccmRCC treated with either systemic therapy (ST), cytoreductive nephrectomy (CN), or both (ST+CN) were identified. Univariable and multivariable Cox-regression models were used. RESULTS: Overall, 993 (32%) contemporary versus 2,106 (68%) historical patients with ccmRCC were identified. Median OS was 41 months in contemporary versus 25 months in historical patients (Δ=16 months; P<.001). In multivariable Cox-regression analyses, contemporary membership was independently associated with lower overall mortality (hazard ratio [HR], 0.7; 95% CI, 0.6-0.8; P<.001). In patients treated with ST alone, median OS was 17 months in contemporary versus 10 months in historical patients (Δ=7 months; P<.001; multivariable HR, 0.7; P=.005). In patients treated with CN alone, median OS was not reached in contemporary versus 33 months in historical patients (Δ=not available; P<.001; multivariable HR, 0.7; P<.001). In patients treated with ST+CN, median OS was 38 months in contemporary versus 26 months in historical patients (Δ=12 months; P<.001; multivariable HR, 0.7; P=.003). CONCLUSIONS: Contemporary community-based patients with ccmRCC receiving active treatment clearly exhibited better survival than their historical counterparts, when examined as one group, as well as when examined as separate subgroups according to treatment type. Treatment advancements of phase III trials seem to be applied appropriately outside of centers of excellence.

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Идентификаторы

DOI: 10.6004/jnccn.2024.7011

Цитирования и источники

Цитирований: 2Использованных источников: 0

Показатели — AkademScholar