PURPOSE: Combination gemcitabine and 5-fluorouracil (5-FU) may have activity in metastatic renal cell cancer. To identify patient subgroups most likely to benefit and compare survival to that in previously described patient series long-term survival as a function of known and suspected prognostic variables was determined. MATERIALS AND METHODS: The survival status of 153 patients with metastatic renal cell cancer treated on 1 phase I and 4 phase II trials of gemcitabine/5-FU based regimens was updated. Univariate and multivariate Cox proportional hazards models were constructed using multiple imputation for missing values. RESULTS: Performance status, prior nephrectomy, number of metastatic sites, decreased albumin and elevated alkaline phosphatase were highly prognostic for survival. Sarcomatoid differentiation and hypercalcemia had borderline prognostic significance. Using a previous described prognostic model that divided patients into 3 risk groups survival in those treated with gemcitabine/5-FU in this series was consistently better than survival in similar patients treated in the Motzer series. CONCLUSIONS: Previously described prognostic factors for survival in metastatic renal cancer were confirmed. There is no clearly identifiable group that is most likely to benefit from a gemcitabine/5-FU regimen but there is a continued suggestion that this regimen provides a modest improvement over historical chemotherapy approaches.
PURPOSE: Combination gemcitabine and 5-fluorouracil (5-FU) may have activity in metastatic renal cell cancer. To identify patient subgroups most likely to benefit and compare survival to that in previously described patient series long-term survival as a function of known and suspected prognostic variables was determined. MATERIALS AND METHODS: The survival status of 153 patients with metastatic renal cell cancer treated on 1 phase I and 4 phase II trials of gemcitabine/5-FU based regimens was updated. Univariate and multivariate Cox proportional hazards models were constructed using multiple imputation for missing values. RESULTS: Performance status, prior nephrectomy, number of metastatic sites, decreased albumin and elevated alkaline phosphatase were highly prognostic for survival. Sarcomatoid differentiation and hypercalcemia had borderline prognostic significance. Using a previous described prognostic model that divided patients into 3 risk groups survival in those treated with gemcitabine/5-FU in this series was consistently better than survival in similar patients treated in the Motzer series. CONCLUSIONS: Previously described prognostic factors for survival in metastatic renal cancer were confirmed. There is no clearly identifiable group that is most likely to benefit from a gemcitabine/5-FU regimen but there is a continued suggestion that this regimen provides a modest improvement over historical chemotherapy approaches.
Authors: Nizar M Tannir; Peter F Thall; Chaan S Ng; Xuemei Wang; Leiko Wooten; Arlene Siefker-Radtke; Paul Mathew; Lance Pagliaro; Christopher Wood; Eric Jonasch Journal: J Urol Date: 2008-07-17 Impact factor: 7.450
Authors: T Qayyum; P A McArdle; G W Lamb; F Jordan; C Orange; M Seywright; P G Horgan; R J Jones; G Oades; M A Aitchison; J Edwards Journal: Br J Cancer Date: 2012-07-19 Impact factor: 7.640
Authors: M D Michaelson; A X Zhu; D P Ryan; D F McDermott; G I Shapiro; L Tye; I Chen; P Stephenson; S Patyna; A Ruiz-Garcia; A B Schwarzberg Journal: Br J Cancer Date: 2013-03-19 Impact factor: 7.640