Department of Urology, Fujita Health University, School of Medicine, Toyoake, Japan
Department of Nephrourology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Anticancer Res. 2020 Aug;40(8):4395-4400. doi: 10.21873/anticanres.14443.
BACKGROUND/AIM: The therapeutic outcomes of patients with metastatic renal cell carcinoma (mRCC) have dramatically improved with the introduction of molecular-targeted agents. The observational multicenter study was conducted to develop a novel stratification system for the intermediate risk group of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model.
The present study included 252 Japanese patients with mRCC who received first-line molecular-targeted therapy at four institutions.
The 252 patients were classified into the favorable, intermediate, and poor risk groups by the IMDC model. For the intermediate risk group, multivariate analysis of the six factors included in the IMDC model revealed that a low performance status, anemia, and a high platelet count were independent predictors of poor overall survival (OS). The intermediate risk group was subsequently divided into the following two groups (int -group 1 and 2) by the three independent OS predictors. Significant differences in the OS were noted among the IMDC favorable risk group, int-group 1, int-group 2, and poor risk group.
The novel stratification presented in this study could be a useful tool for further prognostication of patients with mRCC classified into the intermediate risk group according to the IMDC model after first-line molecular-targeted therapy.
背景/目的：随着分子靶向药物的引入，转移性肾细胞癌（mRCC）患者的治疗效果有了显著改善。本观察性多中心研究旨在为国际转移性肾细胞癌数据库联盟（IMDC）模型的中间风险组开发一种新的分层系统。
本研究纳入了在四家机构接受一线分子靶向治疗的 252 例 mRCC 日本患者。
252 例患者按 IMDC 模型分为预后良好、预后中等和预后不良风险组。对 IMDC 模型中包含的 6 个因素进行多因素分析显示，低体能状态、贫血和高血小板计数是总生存（OS）不良的独立预测因素。随后，根据这三个独立的 OS 预测因素，将中间风险组进一步分为以下两组（int 组 1 和 2）。在 IMDC 预后良好组、int 组 1、int 组 2 和预后不良组之间，OS 差异有统计学意义。
本研究提出的新分层方法可能是在一线分子靶向治疗后根据 IMDC 模型将 mRCC 患者分为中间风险组进行进一步预后预测的有用工具。
