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转移性非透明细胞肾细胞癌的临床特征和预后因素:来自土耳其肿瘤学组肾癌联盟的多中心研究。

Clinical Features and Prognostic Factors of Metastatic Non-Clear Cell Renal Cell Carcinoma: A Multicenter Study from the Turkish Oncology Group Kidney Cancer Consortium.

机构信息

Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.

Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey.

出版信息

Urol Int. 2023;107(6):595-601. doi: 10.1159/000528994. Epub 2023 Mar 30.

Abstract

INTRODUCTION

We aimed to evaluate clinical features, prognostic factors, and treatment preferences in patients with non-clear cell renal cell carcinoma (nccRCC).

METHODS

Patients with metastatic nccRCC were selected from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database. Clinical features, prognostic factors, and overall survival (OS) outcomes were investigated.

RESULTS

A total of 118 patients diagnosed with nccRCC were included in this study. The median age at diagnosis was 62 years (interquartile range: 56-69). Papillary (57.6%) and chromophobe tumors (12.7%) are common histologic subtypes. Sarcomatoid differentiation was present in 19.5% of all patients. When the patients were categorized according to the International Metastatic RCC Database Consortium (IMDC) risk scores, 66.9% of the patients were found to be in the intermediate or poor risk group. Approximately half of the patients (55.9%) received interferon in the first line. At the median follow-up of 53.2 months (95% confidence interval [CI]: 34.7-71.8), the median OS was 19.3 months (95% CI: 14.1-24.5). In multivariate analysis, lung metastasis (hazard ratio [HR]:2.22, 95% CI: 1.23-3.99) and IMDC risk score (HR: 2.35, 95% CI: 1.01-5.44 for intermediate risk; HR: 8.86, 95% CI: 3.47-22.61 for poor risk) were found to be independent prognostic factors.

CONCLUSION

In this study, survival outcomes are consistent with previous studies. The IMDC risk score and lung metastasis are the independent prognostic factors for OS. This is an area that needs research to better treat this group of patients and create new treatment options.

摘要

介绍

我们旨在评估非透明细胞肾细胞癌(nccRCC)患者的临床特征、预后因素和治疗偏好。

方法

从土耳其肿瘤学会肾癌协作组(TKCC)数据库中选择转移性 nccRCC 患者。研究了临床特征、预后因素和总生存期(OS)结果。

结果

本研究共纳入 118 例 nccRCC 患者。诊断时的中位年龄为 62 岁(四分位距:56-69)。乳头状(57.6%)和嫌色细胞肿瘤(12.7%)是常见的组织学亚型。所有患者中有 19.5%存在肉瘤样分化。根据国际转移性肾细胞癌数据库联盟(IMDC)风险评分,66.9%的患者被归类为中危或高危组。大约一半的患者(55.9%)在一线接受干扰素治疗。在中位随访 53.2 个月(95%置信区间[CI]:34.7-71.8)时,中位 OS 为 19.3 个月(95%CI:14.1-24.5)。多变量分析显示,肺转移(风险比[HR]:2.22,95%CI:1.23-3.99)和 IMDC 风险评分(HR:中危组为 2.35,95%CI:1.01-5.44;高危组为 8.86,95%CI:3.47-22.61)是独立的预后因素。

结论

在这项研究中,生存结果与以往研究一致。IMDC 风险评分和肺转移是 OS 的独立预后因素。这是一个需要研究的领域,以便为这组患者提供更好的治疗并创造新的治疗选择。

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