Hazem I Assi1, Francois Patenaude2, Ethan Toumishey3, Laura Ross4, Mahmoud Abdelsalam4, Tony Reiman5. 1. Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Centre, American University of Beirut, Lebanon;; Department of Medicine, Dalhousie University, Halifax, NS, Canada; 2. Segal Cancer Centre, Jewish General Hospital, Department of Oncology and Department of Medicine, Hematology Division, Montreal, QC, Canada; 3. Dalhousie Medicine New Brunswick, Saint John, NB, Canada; 4. Division of Medical Oncology, The Moncton Hospital, Moncton, NB, Canada; 5. Department of Medicine, Dalhousie University, Halifax, NS, Canada;; Department of Oncology, Saint John Regional Hospital, Saint John, NB, Canada;; Department of Biology, University of New Brunswick, Fredericton, NB, Canada.
Abstract
INTRODUCTION: The primary purpose of this study was to develop a simpler prognostic model to predict overall survival for patients treated for metastatic renal cell carcinoma (mRCC) by examining variables shown in the literature to be associated with survival. METHODS: We conducted a retrospective analysis of patients treated for mRCC at two Canadian centres. All patients who started first-line treatment were included in the analysis. A multivariate Cox proportional hazards regression model was constructed using a stepwise procedure. Patients were assigned to risk groups depending on how many of the three risk factors from the final multivariate model they had. RESULTS: There were three risk factors in the final multivariate model: hemoglobin, prior nephrectomy, and time from diagnosis to treatment. Patients in the high-risk group (two or three risk factors) had a median survival of 5.9 months, while those in the intermediate-risk group (one risk factor) had a median survival of 16.2 months, and those in the low-risk group (no risk factors) had a median survival of 50.6 months. CONCLUSIONS: In multivariate analysis, shorter survival times were associated with hemoglobin below the lower limit of normal, absence of prior nephrectomy, and initiation of treatment within one year of diagnosis.
INTRODUCTION: The primary purpose of this study was to develop a simpler prognostic model to predict overall survival for patients treated for metastatic renal cell carcinoma (mRCC) by examining variables shown in the literature to be associated with survival. METHODS: We conducted a retrospective analysis of patients treated for mRCC at two Canadian centres. All patients who started first-line treatment were included in the analysis. A multivariate Cox proportional hazards regression model was constructed using a stepwise procedure. Patients were assigned to risk groups depending on how many of the three risk factors from the final multivariate model they had. RESULTS: There were three risk factors in the final multivariate model: hemoglobin, prior nephrectomy, and time from diagnosis to treatment. Patients in the high-risk group (two or three risk factors) had a median survival of 5.9 months, while those in the intermediate-risk group (one risk factor) had a median survival of 16.2 months, and those in the low-risk group (no risk factors) had a median survival of 50.6 months. CONCLUSIONS: In multivariate analysis, shorter survival times were associated with hemoglobin below the lower limit of normal, absence of prior nephrectomy, and initiation of treatment within one year of diagnosis.
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