The effect of metastatic focus on survival after cytoreductive nephrectomy in renal cell carcinoma: experience of a single center
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
INTRODUCTION: Despite the newly developed targeted therapies in metastatic renal cell carcinoma (RCC),survival rates are still low.The most common metastatic areas are lung, liver and bone. Among these, especiallycases with bone metastasis are associated with worse prognosis. In this study, we aimed to determine the effectof metastatic focus on oncologic outcomes in RCC and to evaluate other prognostic factors affecting overallsurvival.METHODS: Between January 2009 and December 2016, 35 patients with metastatic RCC who underwentcytoreductive nephrectomy were evaluated retrospectively.Demographic, pathological, clinical data, progressionstatus and survival outcomes after nephrectomy were recorded and the patients were divided into two groups:those with bone metastases (Group I) and those with only visceral organ metastasis (Group II). RESULTS: The mean age of the patients was 59.20±11.72 years.During the median follow-up period of 11 (2-90) months, 25 patients (71.4%) had progression and 27 patients (77.1%) died.IMDC risk score(p=0.008),MSKCC risk score (p=0.025), progression rate (85.0% vs 53.3%, p=0.04) and mortality rate (90.0%vs 60.0%), p = 0.036) were found to be significantly higher in Group I. The predicted overall survival wassignificantly lower in Group I (18.60 vs. 43.60 months, p=0.036).In multivariate analysis, IMDC score wasfound to be independent predictor for progression-free survival. On the other hand, Fuhrman grade, boneinvolvement and IMDC score were independent predictors for overall survival.DISCUSSION AND CONCLUSION: It is seen that overall survival decreases especially in the presence ofaccompanying visceral organ metastasis, multiple or axial bone involvement in RCC with bonemetastases.Closer follow-up is required for cases with bone metastasis because these patients have worseprognosis than those with visceral organ involvement except for brain.In addition, the rates of bone-relatedevents are higher in these patients and cause decrease in quality of life.Therefore, different local palliativetreatments for bone should be chosen more carefully.
Açıklama
Anahtar Kelimeler
Tıbbi İnformatik, Genel ve Dahili Tıp, Temel Sağlık Hizmetleri, Onkoloji, Sağlık Bilimleri ve Hizmetleri
Kaynak
ACTA ONCOLOGICA TURCICA
WoS Q Değeri
Scopus Q Değeri
Cilt
52
Sayı
2
