a Department of Immunology Genetics and Pathology , Uppsala University, Rudbecklaboratoriet , Uppsala , Sweden.
b Department of Urology , Ludwig-Maximilians University , Munich , Germany.
Acta Oncol. 2019 Mar;58(3):306-312. doi: 10.1080/0284186X.2018.1537505. Epub 2018 Dec 3.
Metastatic papillary renal cell carcinoma (mPRCC) is understudied. The disease is often aggressive and specific treatment options are lacking.
mPRCC patients (n = 86) referred to three academic centres in Sweden and Germany in the years 2005-2015 were retrospectively identified from medical records. Statistical analyses included Kaplan-Meier curves and calculation of Cox proportional hazards, generating hazard ratios with 95% confidence intervals. The aim of the study was to evaluate overall survival (OS) of mPRCC patients treated outside of clinical trials in the era of targeted agents (TA) and to identify clinically useful prognostic factors.
Median OS of all mPRCC patients was 11.2 months. TA were used in 77% of the patients and associated with younger age and better Eastern Cooperative Oncology Group performance status (PS). Brain metastases were common (28%). Patients with synchronous or metachronous metastases had similar OS. Variables independently associated with risk of death included age ≥60 years, worse PS and ≥3 metastatic sites. The MSKCC criteria did not provide additional prognostic information. A subgroup analysis of TA-treated patients revealed an association of lymph node metastasis with risk of death in addition to the other prognostic factors.
OS in mPRCC remained short in the era of targeted agents. Age, PS, and number of metastatic sites provided independent prognostic information.
转移性乳头状肾细胞癌（mPRCC）研究不足。该疾病通常具有侵袭性，且缺乏特定的治疗选择。
从 2005 年至 2015 年，对瑞典和德国的三个学术中心的 86 例 mPRCC 患者的病历进行了回顾性分析。统计分析包括 Kaplan-Meier 曲线和 Cox 比例风险计算，生成具有 95%置信区间的风险比。本研究旨在评估靶向治疗时代（TA）临床试验之外治疗的 mPRCC 患者的总生存期（OS），并确定临床有用的预后因素。
所有 mPRCC 患者的中位 OS 为 11.2 个月。77%的患者使用了 TA，与年轻年龄和更好的东部合作肿瘤学组表现状态（PS）相关。脑转移很常见（28%）。同步或异时转移的患者具有相似的 OS。与死亡风险相关的独立变量包括年龄≥60 岁、PS 较差和≥3 个转移部位。MSKCC 标准未提供额外的预后信息。TA 治疗患者的亚组分析显示，淋巴结转移与其他预后因素一起与死亡风险相关。
在靶向治疗时代，mPRCC 的 OS 仍然较短。年龄、PS 和转移部位的数量提供了独立的预后信息。
