Nobuyuki Tanaka1, Ryuichi Mizuno2, Keiichi Ito3, Suguru Shirotake4, Yota Yasumizu4, Ayako Masunaga3, Yujiro Ito5, Yasumasa Miyazaki2, Masayuki Hagiwara6, Kent Kanao7, Shuji Mikami8, Ken Nakagawa6, Tetsuo Momma9, Takeshi Masuda10, Tomohiko Asano3, Masafumi Oyama4, Mototsugu Oya2. 1. Department of Urology, Keio University School of Medicine, Tokyo, Japan; Department of Urology, Saitama City Hospital, Saitama, Japan. Electronic address: urotanaka@gmail.com. 2. Department of Urology, Keio University School of Medicine, Tokyo, Japan. 3. Department of Urology, National Defense Medical College, Tokorozawa, Japan. 4. Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan. 5. Department of Urology, Saiseikai Central Hospital, Tokyo, Japan. 6. Department of Urology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Japan. 7. Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan. 8. Division of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan. 9. Department of Urology, National Hospital Organization Saitama Hospital, Wako, Japan. 10. Department of Urology, Saitama City Hospital, Saitama, Japan.
Abstract
BACKGROUND: Two risk models, the Memorial Sloan Kettering Cancer Center (MSKCC) model and the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model, have been studied in metastatic renal cell carcinoma (mRCC) treated with targeted therapy. OBJECTIVE: To validate externally the predictive accuracies of the MSKCC and IMDC models for prognosis in mRCC patients treated with first-line and subsequent second-line targeted therapy. DESIGN, SETTING, AND PARTICIPANTS: A total of 311 patients were assessed retrospectively. INTERVENTION: All patients underwent targeted therapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Survival outcomes were assessed using Kaplan-Meier analysis. The predictive ability was evaluated using the c-index. RESULTS AND LIMITATIONS: Regarding to the first-line targeted therapy, the 3-yr overall survival (OS) rates of the MSKCC (p<0.001) and IMDC models (p<0.001) were 76.2% and 77.3%, respectively, in the favorable-risk group; 46.7% and 47.9%, respectively, in the intermediate-risk group; and 13.4% and 15.6%, respectively, in the poor-risk group. The c-indexes were 0.68 for the MSKCC model and 0.69 for the IMDC model in a first-line setting. Regarding the second-line targeted therapy, the 1-yr OS rates of the MSKCC (p<0.001) and IMDC models (p<0.001) were 80.9% and 90.5%, respectively, in the favorable-risk group; 71.4% and 70.6%, respectively, in the intermediate-risk group; and 31.7% and 24.6%, respectively, in the poor-risk group. The c-indexes were 0.66 for the MSKCC model and 0.65 for the IMDC model in the second-line setting. The study is limited by its retrospective nature. CONCLUSIONS: The results may assist physicians in providing more appropriate patient counseling and imply the need for a future prognostic tool in mRCC treated with targeted therapy. PATIENT SUMMARY: Both risk models were useful for the risk stratification in metastatic renal cell carcinoma (mRCC) patients treated with first-line and second-line targeted therapy; however, it might be necessary to further update or optimize the models for our Japanese cohort of mRCC patients.
BACKGROUND: Two risk models, the Memorial Sloan Kettering Cancer Center (MSKCC) model and the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model, have been studied in metastatic renal cell carcinoma (mRCC) treated with targeted therapy. OBJECTIVE: To validate externally the predictive accuracies of the MSKCC and IMDC models for prognosis in mRCC patients treated with first-line and subsequent second-line targeted therapy. DESIGN, SETTING, AND PARTICIPANTS: A total of 311 patients were assessed retrospectively. INTERVENTION: All patients underwent targeted therapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Survival outcomes were assessed using Kaplan-Meier analysis. The predictive ability was evaluated using the c-index. RESULTS AND LIMITATIONS: Regarding to the first-line targeted therapy, the 3-yr overall survival (OS) rates of the MSKCC (p<0.001) and IMDC models (p<0.001) were 76.2% and 77.3%, respectively, in the favorable-risk group; 46.7% and 47.9%, respectively, in the intermediate-risk group; and 13.4% and 15.6%, respectively, in the poor-risk group. The c-indexes were 0.68 for the MSKCC model and 0.69 for the IMDC model in a first-line setting. Regarding the second-line targeted therapy, the 1-yr OS rates of the MSKCC (p<0.001) and IMDC models (p<0.001) were 80.9% and 90.5%, respectively, in the favorable-risk group; 71.4% and 70.6%, respectively, in the intermediate-risk group; and 31.7% and 24.6%, respectively, in the poor-risk group. The c-indexes were 0.66 for the MSKCC model and 0.65 for the IMDC model in the second-line setting. The study is limited by its retrospective nature. CONCLUSIONS: The results may assist physicians in providing more appropriate patient counseling and imply the need for a future prognostic tool in mRCC treated with targeted therapy. PATIENT SUMMARY: Both risk models were useful for the risk stratification in metastatic renal cell carcinoma (mRCC) patients treated with first-line and second-line targeted therapy; however, it might be necessary to further update or optimize the models for our Japanese cohort of mRCC patients.
Authors: Dylan J Martini; Yuan Liu; Julie M Shabto; Bradley C Carthon; Emilie Elise Hitron; Greta Anne Russler; Sarah Caulfield; Haydn T Kissick; Wayne B Harris; Omer Kucuk; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2019-12-05
Authors: Marie-France Savard; J Connor Wells; Jeffrey Graham; Shaan Dudani; John A Steinharter; Bradley A McGregor; Frede Donskov; Georg A Bjarnason; Ulka N Vaishampayan; Aaron R Hansen; Marco A J Iafolla; Giovanni Zanotti; Lynn Huynh; Rose Chang; Mei S Duh; Daniel Y C Heng Journal: Oncologist Date: 2020-01-23
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Authors: Youn I Choi; Jun-Won Chung; Kyoung Oh Kim; Kwang An Kwon; Yoon Jae Kim; Dong Kyun Park; Sung Min Ahn; So Hyun Park; Sun Jin Sym; Dong Bok Shin; Young Saing Kim; Ki Hoon Sung; Jeong-Heum Baek; Uhn Lee Journal: Can J Gastroenterol Hepatol Date: 2019-02-03
Authors: Dylan J Martini; Yuan Liu; Julie M Shabto; Bradley C Carthon; Emilie Elise Hitron; Greta Anne Russler; Sarah Caulfield; Haydn T Kissick; Wayne B Harris; Omer Kucuk; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2019-12-05