Derya Tilki1, Brian Hu2, Hao G Nguyen3, Marc A Dall'Era3, Roberto Bertini4, Joaquín A Carballido5, Thenappan Chandrasekar3, Thomas Chromecki6, Gaetano Ciancio7, Siamak Daneshmand8, Paolo Gontero9, Javier Gonzalez10, Axel Haferkamp11, Markus Hohenfellner12, William C Huang13, Theresa M Koppie14, Estefania Linares5, C Adam Lorentz15, Philipp Mandel16, Juan I Martinez-Salamanca5, Viraj A Master15, Rayan Matloob4, James M McKiernan17, Carrie M Mlynarczyk17, Francesco Montorsi4, Giacomo Novara18, Sascha Pahernik12, Juan Palou19, Raj S Pruthi20, Krishna Ramaswamy13, Oscar Rodriguez Faba19, Paul Russo21, Shahrokh F Shariat22, Martin Spahn23, Carlo Terrone24, William Thieu3, Daniel Vergho23, Eric M Wallen20, Evanguelos Xylinas25, Richard Zigeuner6, John A Libertino26, Christopher P Evans3. 1. Department of Urology, University of California, Davis School of Medicine, Sacramento, California. Electronic address: derya.tilki@ucdmc.ucdavis.edu. 2. Department of Urology, University of California, Davis School of Medicine, Sacramento, California; USC/Norris Comprehensive Cancer Center, Los Angeles, California. 3. Department of Urology, University of California, Davis School of Medicine, Sacramento, California. 4. Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy. 5. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain. 6. Department of Urology, Medical University of Graz, Graz, Austria. 7. Miami Transplant Institute, University of Miami, Miami, Florida. 8. USC/Norris Comprehensive Cancer Center, Los Angeles, California. 9. Department of Urology, A.O.U. San Giovanni Battista, University of Turin, Turin, Italy. 10. Department of Urology, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain. 11. Department of Urology, University of Frankfurt, Frankfurt, Germany. 12. Department of Urology, University of Heidelberg, Heidelberg, Germany. 13. Department of Urology, New York University School of Medicine, New York, New York. 14. Department of Urology, Oregon Health & Science University, Portland, Oregon. 15. Department of Urology, Emory University, Atlanta, Georgia. 16. Institute of Empirical Economic Research, University of Leipzig, Leipzig, Germany. 17. Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York. 18. University of Padua, Padua, Italy. 19. Department of Urology, Fundació Puigvert, Barcelona, Spain. 20. Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 21. Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York. 22. Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria. 23. University of Würzburg, Würzburg, Germany. 24. Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy. 25. Department of Urology, Weill Cornell Medical Center, New York, New York. 26. Department of Urology, Lahey Clinic, Burlington, Massachusetts.
Abstract
PURPOSE: Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. MATERIALS AND METHODS: The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. RESULTS: Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. CONCLUSIONS: In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.
PURPOSE:Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. MATERIALS AND METHODS: The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patientcancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. RESULTS: Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. CONCLUSIONS: In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.
Authors: Renzo G DiNatale; Wanling Xie; Maria F Becerra; Andrew W Silagy; Kyrollis Attalla; Alejandro Sanchez; Roy Mano; Julian Marcon; Kyle A Blum; Nicole E Benfante; Martin H Voss; Robert J Motzer; Jonathan Coleman; Toni K Choueiri; Ed Reznik; Paul Russo; Daniel Y C Heng; A Ari Hakimi Journal: Eur Urol Oncol Date: 2019-11-14
Authors: Rene Mager; Siamak Daneshmand; Christopher P Evans; Joan Palou; Juan I Martínez-Salamanca; Viraj A Master; James M McKiernan; John A Libertino; Axel Haferkamp; Axel Haferkamp; Umberto Capitanio; Joaquín A Carballido; Venancio Chantada; Thomas Chromecki; Gaetano Ciancio; Siamak Daneshmand; Christopher P Evans; Paolo Gontero; Javier González; Markus Hohenfellner; William C Huang; Theresa M Koppie; John A Libertino; Estefanía Linares Espinós; Adam Lorentz; Juan I Martínez-Salamanca; Viraj A Master; James M McKiernan; Francesco Montorsi; Giacomo Novara; Padraic O'Malley; Sascha Pahernik; Joan Palou; José Luis Pontones Moreno; Raj S Pruthi; Oscar Rodriguez Faba; Paul Russo; Douglas S Scherr; Shahrokh F Shariat; Martin Spahn; Carlo Terrone; Derya Tilki; Dario Vázquez-Martul; Cesar Vera Donoso; Daniel Vergho; Eric M Wallen; Richard Zigeuner Journal: J Surg Oncol Date: 2016-08-26 Impact factor: 3.454
Authors: Kyo Chul Koo; Kwang Suk Lee; Kang Su Cho; Koon Ho Rha; Sung Joon Hong; Byung Ha Chung Journal: Int Urol Nephrol Date: 2016-03-05 Impact factor: 2.370
Authors: Alberto C Pieretti; Manuel Ozambela; Mary E Westerman; Graciela M Nogueras-Gonzalez; Luis A Segarra; Niki M Zacharias; Ara Vaporciyan; Wayne Hofstetter; Tam Huynh; Saad Aldousari; Surena F Matin; Jose A Karam Journal: Clin Genitourin Cancer Date: 2022-02-09 Impact factor: 3.121