Department of Urology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2024 Nov 25;39(45):e293. doi: 10.3346/jkms.2024.39.e293.
In patients with metastatic renal cell carcinoma (mRCC), sites of metastatic involvement have been reported to be associated with a difference in survival. However, the frequency and survival according to different sites of metastases in Korean patients with mRCC remain unclear. Therefore, this study aimed to assess the frequency of metastatic site involvement and the association between sites of metastatic involvement and survival in Korean patients with mRCC.
This retrospective study used the multicenter cohort of the Korean Renal Cancer Study Group mRCC database to identify patients who started targeted therapy between December 2005 and March 2018. Data on the frequency of metastatic organ involvement at the time of mRCC diagnosis and oncologic outcomes according to different sites of metastasis were analyzed.
A total of 1,761 patients were eligible for analysis. Of the 1,761 patients, 1,564 (88.8%) had clear cell RCC, and 1,040 (59.1%) had synchronous metastasis. The median number of metastasis sites was 2 (interquartile range [IQR], 1-6). The median age at the initiation of systemic therapy was 60 years (IQR, 29-88), 1,380 (78.4%) were men, and 1,341 (76.1%) underwent nephrectomy. Based on the International Metastatic Renal Cell Carcinoma Database Consortium model, patients were stratified into favorable-, intermediate-, and poor-risk groups with 359 (20.4%), 1,092 (62.0%), and 310 (17.6%) patients, respectively. The lung (70.9%), lymph nodes (37.9%), bone (30.7%), liver (12.7%), adrenal gland (9.8%), and brain (8.2%) were the most common sites of metastasis, followed by the pancreas, pleura, peritoneum, spleen, thyroid, and bowel. Among the most common sites of metastasis (> 5%), the median cancer-specific survival (CSS) ranged from 13.9 (liver) to 29.1 months (lung). An association was observed between liver, bone, and pleural metastases and the shortest median CSS (< 19 months).
In Korean patients with mRCC, metastases to the lung, lymph nodes, bone, liver, adrenal gland, and brain were more frequent than those to other organs. Metastases to the liver, bone, and pleura were associated with poor CSS. The findings of this study may be valuable for patient counseling and guiding future study designs.
在转移性肾细胞癌（mRCC）患者中，转移性病变部位与生存差异有关。然而，韩国 mRCC 患者不同转移部位的频率和生存情况尚不清楚。因此，本研究旨在评估韩国 mRCC 患者转移部位受累的频率以及转移部位与生存之间的关系。
本回顾性研究使用韩国肾癌研究组 mRCC 数据库的多中心队列，纳入 2005 年 12 月至 2018 年 3 月期间开始靶向治疗的患者。分析 mRCC 诊断时转移性器官受累的频率以及根据不同转移部位的肿瘤学结局。
共纳入 1761 例患者进行分析。1761 例患者中，1564 例（88.8%）为透明细胞肾细胞癌，1040 例（59.1%）为同步转移。转移部位中位数为 2 个（四分位距[IQR]，1-6）。系统治疗开始时的中位年龄为 60 岁（IQR，29-88），1380 例（78.4%）为男性，1341 例（76.1%）行肾切除术。根据国际转移性肾细胞癌数据库联盟模型，患者被分为预后良好组、中危组和预后不良组，分别有 359 例（20.4%）、1092 例（62.0%）和 310 例（17.6%）患者。肺（70.9%）、淋巴结（37.9%）、骨（30.7%）、肝（12.7%）、肾上腺（9.8%）和脑（8.2%）是最常见的转移部位，其次是胰腺、胸膜、腹膜、脾脏、甲状腺和肠道。在最常见的转移部位（>5%）中，中位癌症特异性生存（CSS）范围为 13.9 个月（肝）至 29.1 个月（肺）。肝、骨和胸膜转移与最短中位 CSS（<19 个月）相关。
在韩国 mRCC 患者中，肺、淋巴结、骨、肝、肾上腺和脑转移比其他器官更常见。肝、骨和胸膜转移与较差的 CSS 相关。本研究结果可为患者咨询和指导未来的研究设计提供参考。
