Beisland Christian, Johannesen Tom B, Klepp Olbjorn, Axcrona Ulrika, Torgersen Knut Martin, Kowalski Jan, Solli Oddvar, Sandin Rickard, Oldenburg Jan
Department of Urology, Haukeland University Hospital; Department of Clinical Medicine, University of Bergen, Bergen.
Department of Registration, Cancer Registry of Norway, Oslo.
Onco Targets Ther. 2017 Jan 16;10:371-385. doi: 10.2147/OTT.S123061. eCollection 2017.
This population-wide retrospective, non-interventional registry study assessed changes in overall survival (OS) and factors influencing OS in Norwegian patients with renal cell carcinoma (RCC).
Two population-wide health registries were used to identify all RCC patients with (mRCC) or without metastases diagnosed before (2002-2005) and after (2006-2008 and 2009-2011) introduction of targeted therapies. Median OS was estimated using Kaplan-Meier method. Cox proportional hazards regression modeling was used to identify prognostic factors.
Overall, 5,463 patients were diagnosed with RCC during 2002-2005 (n=1,898), 2006-2008 (n=1,631), and 2009-2011 (n=1,934); of these, 1,678 (31%) had mRCC. Patients diagnosed in 2009-2011 and 2006-2008 had significant (<0.001) improvements in OS versus those diagnosed in 2002-2005: median OS, not reached and not reached versus 82.0 months in RCC; 14.0 and 12.0 months versus 9.0 months in mRCC. Similarly, OS improvements were seen in the primary and elderly (≥75 years) mRCC populations. Median OS was comparable (12 months) between clear cell and papillary mRCC, but it was longer (24.0 months) for chromophobe mRCC. Multivariate regression analyses showed that younger age, previous nephrectomy, and 1 or more prescriptions of targeted therapy were significantly associated with longer OS in mRCC patients.
OS increased in RCC and mRCC patients in Norway between 2002 and 2011 following introduction of targeted therapies.
这项全人群回顾性、非干预性注册研究评估了挪威肾细胞癌（RCC）患者的总生存期（OS）变化及影响OS的因素。
利用两个全人群健康注册库来识别所有在引入靶向治疗之前（2002 - 2005年）以及之后（2006 - 2008年和2009 - 2011年）被诊断为有（mRCC）或无转移的RCC患者。采用Kaplan - Meier方法估计中位OS。使用Cox比例风险回归模型来识别预后因素。
总体而言，在2002 - 2005年（n = 1898）、2006 - 2008年（n = 1631）和2009 - 2011年（n = 1934）期间，共有5463例患者被诊断为RCC；其中，1678例（31%）有mRCC。与2002 - 2005年诊断的患者相比，2009 - 2011年和2006 - 2008年诊断的患者的OS有显著改善（<0.001）：RCC患者的中位OS，2009 - 2011年和2006 - 2008年未达到，而2002 - 2005年为82.0个月；mRCC患者的中位OS，2009 - 2011年和2006 - 2008年分别为14.0个月和12.0个月，而2002 - 2005年为9.0个月。同样，在原发性和老年（≥75岁）mRCC人群中也观察到OS改善。透明细胞型和乳头状mRCC的中位OS相当（12个月），但嫌色细胞型mRCC的中位OS更长（24.0个月）。多变量回归分析显示，年龄较小、既往肾切除术以及1种或更多种靶向治疗处方与mRCC患者的OS延长显著相关。
在2002年至2011年期间，挪威RCC和mRCC患者在引入靶向治疗后OS有所增加。
