Evidence map›Paper›PMID 36313210›Full record

ArticleAmerican journal of clinical and experimental urology2022

Prognostic significance of sarcomatoid features in metastatic renal cell carcinoma treated with cytoreductive nephrectomy and targeted therapy.

Brian D Cortese, Raju Chelluri, Leilei Xia, David A Ostrowski, Daniel S Roberson, Marshall Strother, James M Ding, Lauren Schwartz, Daniel J Lee, Thomas J Guzzo

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Article in American journal of clinical and experimental urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Brian D CorteseDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
Raju ChelluriDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
Leilei XiaDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
David A OstrowskiDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
Daniel S RobersonDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
Marshall StrotherDivision of Urology and Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center Philadelphia, PA, USA.
James M DingDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
Lauren SchwartzDepartment of Pathology, University of Pennsylvania Health System Philadelphia, PA, USA.
Daniel J LeeDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.
Thomas J GuzzoDivision of Urology, Department of Surgery, University of Pennsylvania Health System Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe presence of sarcomatoid features in localized renal cell carcinoma (RCC) is associated with worse outcomes. We sought to use a national database to evaluate the outcomes and prognosis of metastatic RCC (mRCC) with sarcomatoid features treated with cytoreductive nephrectomy (CN) and targeted therapy (TT).

methodsThe National Cancer Database (2010-2013) was used to identify patients with mRCC at diagnosis. Only patients who underwent CN followed by TT were included. Kaplan-Meier curves, log-rank test, and multivariate Cox regression analysis were used to compare overall survival (OS) between mRCC with and without sarcomatoid features. Subgroup analysis in patients with clear cell RCC (ccRCC) was performed.

resultsA total of 1,427 patients with mRCC treated with CN followed by TT were included of which 364 (26%) had mRCC with sarcomatoid features. mRCC with sarcomatoid features were more likely to have Fuhrman grade 4 cancer. mRCC with sarcomatoid features had worse OS than mRCC without sarcomatoid features (24.6 vs 12.0 months, P < 0.001). For the clear cell cohort, mRCC with sarcomatoid features had worse OS than mRCC without sarcomatoid features (26.2 vs 14.0 months, P < 0.001). Multivariate Cox regression showed sarcomatoid features was significantly associated with worse OS in the overall cohort (hazard ratio [HR] =1.63, 95% confidence interval [CI] =1.38-1.91, P < 0.001) and the ccRCC subcohort (HR=1.53, 95% CI=1.23-1.90, P < 0.001). DISCUSSION/

conclusionmRCC with sarcomatoid features treated with CN and TT has a very poor and drastically different prognosis compared with mRCC without sarcomatoid features. With the expansion of systemic RCC therapies, investigation is needed to optimize treatment in this high-risk cohort.

Indexed as

Carcinomacytoreduction surgical proceduresmolecular targeted therapynephrectomyprognosisrenal cell

Identifiers

PMID36313210
PMCPMC9605937

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