Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy
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 c...
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| Main Authors: | , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
1 Feb 2015
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| In: |
The journal of urology
Year: 2015, Volume: 193, Issue: 2, Pages: 436-442 |
| ISSN: | 1527-3792 |
| DOI: | 10.1016/j.juro.2014.07.087 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.juro.2014.07.087 Verlag, lizenzpflichtig, Volltext: https://www.auajournals.org/doi/10.1016/j.juro.2014.07.087 
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| Author Notes: | Tilki Derya, Hu Brian, Nguyen Hao G., Dall’Era Marc A., Bertini Roberto, Carballido Joaquín A., Chandrasekar Thenappan, Chromecki Thomas, Ciancio Gaetano, Daneshmand Siamak, Gontero Paolo, Gonzalez Javier, Haferkamp Axel, Hohenfellner Markus, Huang William C., Koppie Theresa M., Linares Estefania, Lorentz C. Adam, Mandel Philipp, Martinez-Salamanca Juan I., Master Viraj A., Matloob Rayan, McKiernan James M., Mlynarczyk Carrie M., Montorsi Francesco, Novara Giacomo, Pahernik Sascha, Palou Juan, Pruthi Raj S., Ramaswamy Krishna, Rodriguez Faba Oscar, Russo Paul, Shariat Shahrokh F., Spahn Martin, Terrone Carlo, Thieu William, Vergho Daniel, Wallen Eric M., Xylinas Evanguelos, Zigeuner Richard, Libertino John A., and Evans Christopher P. |
| Summary: | 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. |
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| Item Description: | Gesehen am 02.07.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1527-3792 |
| DOI: | 10.1016/j.juro.2014.07.087 |