Kidneys, adrenal glands, genitourinary system, body scan, joints, 3D rendering of medical screen, human anatomy, computer anatomy, body skeleton, x-ray scan: © Leo Viktorov – Stock.adobe.com
Real-life retrospective data showed that morphological renal cell carcinoma (RCC) type and tumor stage are helpful in providing information on recurrence and prognosis. The researchers evaluated disease-free survival (DFS) and overall survival (OS) measured at two and five years, according to the findings presented in a poster. 2024 ASCO Genitourinary Cancer Symposium.1
“Our study provides real-world recurrence and survival rates. [however]”A major limitation is the retrospective nature of the analysis,” the researchers wrote in the poster.
Actual data is based on tumor node metastasis (TNM) stage 1, 2, or 3 and histology, clear cell renal cell carcinoma (ccRCC), papillary renal cell carcinoma (pRCC), and other histology. organized into three main groups. specified (NOS).
Patients in the TNM stage 1 ccRCC group had a DFS of 90.4% (CI 95%, 87.1% to 94%) at 2 years and 78.9% (CI 95%, 73.6% to 84.5%) at 5 years. Ta. OS in this group was 95.2% (CI 95%, 93.2% to 97.2%) at 2 years and 86.5% (CI 95%, 82.8% to 90.4%) at 5 years. These percentages decreased by TNM stage, with ccRCC TNM stage 3 patients having 70.6% (CI 95%, 61.1% to 81.5%) at 2 years and 46.5% (CI 95%, 34.9% to 5) at 5 years. showed a DFS of 62.1%). Survival rate was 89.3% (CI 95%, 83.7% to 95.2%) at 2 years and 70% (CI 95%, 60.2% to 81.3%) at 5 years.
For patients in the TNM stage 1 pRCC group, DFS was 93.9% (CI 95%, 89.2% to 98.8%) after 2 years and 88.5% (CI 95%, 81.0% to 97.8%) after 5 years . OS was 94.8% (CI 95%, 91.1% to 98.6%) at 2 years and 88% (CI 95%, 82.2% to 94.2%) at 5 years. For this group of patients with TNM stage 3, DFS at 2 years was 47.1% (CI 95%, 26.5% to 83.8%) and DFS at 5 years was 23.6% (CI 95%, 7.6% to 73.4%) , OS was 70.4% (CI 95%, 51.5% to 96.2%) at 2 years and 41.1% (CI 95%, 20.5% to 82.5%) at 5 years.
In the TNM stage 1 NOS RCC group, DFS was 89% (CI 95%, 81% to 97.8%) at 2 years and 79.7% (CI 95%, 69.1% to 92.0%) at 2 years. OS was 95.4% (CI 95%, 91.1% to 99.9%) at 2 years and 85.9% (CI 95%, 77.2% to 95.5%) at 5 years. For this group of TNM stage 3 patients, the DFS at 2 years was 73% (CI 95%, 56.5% to 94.3%) and the DFS at 5 years was 44.6% (CI 95%, 25.3% to 78.4%) , which was the OS two years later. It was 84.5% (CI 95%, 71.6% to 99.8%) after 1 year and 53.5% (CI 95%, 43.2% to 83.7%) after 5 years.
Total DFS at 5 years for patients with ccRCC was 83.2% (CI 95%, 80.6% to 86.9%) and total OS was 82.7% (CI 95%, 79.2% to 86.3%). For pRCC patients, total DFS at 5 years was 85.9% (CI 95%, 81.2% to 90.8%) and total OS was 82.0% (CI 95%, 75.9% to 88.7%). Total DFS at 5 years for NOS patients was 87.0% (CI 95%, 82.0% to 92.5%) and total OS was 77.2% (CI 95%, 68.8% to 86.6%).
This analysis included adult patients who underwent regular treatment and nephron-sparing surgery or nephrectomy for non-metastatic RCC at a tertiary cancer center in Germany between 2013 and 2022. Patients with clear cell, papillary, or NOS histology were included. The primary objective of the review was to assess DFS and OS using Kaplan-Meier analysis stratified by pathological stage.
Of the patients evaluated in the review, 1,291 underwent nephron-sparing surgery or nephrectomy, and 1,271 (98.5%) of these patients had R0 or R1 resection margins. Median follow-up was 37.8 months (interquartile range, 13.08-65.74). Of all patients included in the review, 754 had ccRCC, mean age was 63.5 years, and 70.0% were male. There were 221 patients with pRCC, mean age 62.1 years, and 78.7% male. There were 165 patients with NOS RCC, mean age 63.3 years, and 67.3% male. Additionally, 129 patients had other histology, mean age was 61.0 years, and 50.4% were male.
Standard treatment for localized renal cell carcinoma includes nephrectomy and the risk-adapted adjuvant pembrolizumab. Risk of recurrence is assessed based on clinical trial results to guide patient counseling. Real-world data are minimal regarding recurrence and survival, and real-world results may differ from those observed in controlled trial settings. In this study, we presented real-world outcome data for RCC patients from the German Cancer Consortium’s Clinical Communication Platform. The platform serves as a federated data warehouse infrastructure specifically designed to collect oncological real-world evidence.
“[Because] “Our study provides advice on real-world recurrence and survival rates in patients with different types of RCC and could be used to advise patients regarding adjuvant therapy in the clinic.” stated in their abstract.
