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Prognostic factors for survival in metastatic renal cell carcinoma patients with brain metastases receiving targeted therapy

Abstract

Background

The primary objective of our study was to examine the clinical outcomes and prognosis of patients with metastatic renal cell carcinoma (mRCC) with brain metastases (BMs) receiving targeted therapy.

Patients and methods

Fifty-eight patients from 16 oncology centers for whom complete clinical data were available were retrospectively reviewed.

Results

The median age was 57 years (range 30-80). Most patients underwent a nephrectomy (n = 41; 70.7%), were male (n = 42; 72.4%) and had clear-cell (CC) RCC (n = 51; 87.9%). Patients were treated with first-line sunitinib (n = 45; 77.6%) or pazopanib (n = 13; 22.4%). The median time from the initial RCC diagnosis to the diagnosis of BMs was 9 months. The median time from the first occurrence of metastasis to the development of BMs was 7 months. The median overall survival (OS) of mRCC patients with BMs was 13 months. Time from the initial diagnosis of systemic metastasis to the development of BMs (<12 months; p = 0.001), histological subtype (non-CC; p<0.05) and number of BMs (≥2; p<0.05) were significantly associated with OS in multivariate analysis. There were no cases of toxic death. One mRCC patient with BMs (1.7%) experienced treatment-related cerebral necrosis. All other toxicities included those commonly observed with VEGF-TKI therapy.

Conclusions

The time from the initial diagnosis of systemic metastasis to the development of BMs (<12 months), a non-CC histological subtype, and a greater number of BMs (≥2) were independent risk factors for a poor prognosis.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000635

Authors

Ibrahim Yildiz, Ahmet Bilici, Nuri Karadurmuş, Leyla Ozer, Deniz Tural, Mehmet A. Kaplan, Tülay Akman, Ibrahim V. Bayoglu, Mükremin Uysal, Yaşar Yildiz, Özgür Tanriverdi, Ozan Yazici, Zeki Sürmeli, Nazim Serdar Turhal, Sevil Bavbek, Fatih Selçukbiricik, Doğan Koca, Mert Basaran

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  •  Department of Medical Oncology, Acibadem University Atakent Hospital, Istanbul - Turkey
  •  Department of Medical Oncology, Istanbul Medipol University, Istanbul - Turkey
  •  Department of Medical Oncology, Gulhane School of Medicine, Ankara - Turkey
  •  Department of Medical Oncology, Bakirköy Education and Research Hospital, Istanbul - Turkey
  •  Department of Medical Oncology, Dicle University, Diyarbakir - Turkey
  •  Department of Medical Oncology, Izmir Tepecik Training and Research Hospital, Izmir - Turkey
  •  Department of Medical Oncology, Sakarya University, Sakarya - Turkey
  •  Department of Medical Oncology, Afyon Kocatepe University, Afyonkarahisar - Turkey
  •  Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir - Turkey
  •  Department of Medical Oncology, Mugla Sitki Kocman University, Mugla - Turkey
  •  Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara - Turkey
  •  Department of Medical Oncology, Ege University, Tulay Aktas Oncology Hospital, Izmir - Turkey
  •  Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Istanbul - Turkey
  •  Department of Medical Oncology, American Hospital, Istanbul - Turkey
  •  Department of Medical Oncology, Koç University Hospital, Istanbul - Turkey
  •  Department of Medical Oncology, VM Medical Park Hospital, Kocaeli - Turkey
  •  Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey

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