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Comparison of survival outcomes in patients with metastatic papillary vs. clear-cell renal cell carcinoma: a propensity-score analysis
- Source :
- World Journal of Urology. 39:461-472
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background: To compare survival outcomes of metastatic patients harbouring either papillary (pRCC) or clear-cell (ccRCC) renal cell carcinoma in overall population and according to treatment modality. Methods: Within the Surveillance, Epidemiology and End Results database (2006–2015), we identified 6800 patients (585 papillary and 6215 clear-cell) with metastatic RCC. Propensity-score (PS) matching, Kaplan–Meier plots and multivariable Cox-regression models (CRMs) were used. Results: Overall, 585 (8.6%) patients harboured pRCC. Rates of nodal metastases were higher in patients with pRCC (49.7 vs. 23.3%; p < 0.001). Median overall survival (OS) was 13 vs. 18months for pRCC vs. ccRCC patients. After multivariable adjustments, no difference in OS was recorded. Furthermore, after propensity-score matching, virtually the same results were recorded. Median OS of pRCC vs. ccRCC was 8 vs. 4months for no treatment (NT), 11 vs. 12months for targeted therapy alone (TT), 17 vs. 35months for cytoreductive nephrectomy alone (CN) and 18 vs. 25months for combination of CN with TT. Conclusions: Metastatic pRCC patients exhibit poor survival, regardless of treatment received. Moreover, pRCC patients are more likely to present nodal metastases, compared to ccRCC patients, as demonstrated by twofold higher rates of lymph node invasion at diagnosis. These observations indicate that papillary variant represents more prognostically unfavorable tumor histology, in the context of metastatic RCC.
- Subjects :
- Oncology
Nephrology
medicine.medical_specialty
Histology
Combination therapy
Urology
Population
030232 urology & nephrology
Context (language use)
Targeted therapy
03 medical and health sciences
0302 clinical medicine
Cytoreductive nephrectomy
Renal cell carcinoma
Internal medicine
Medicine
education
Lymph node
education.field_of_study
business.industry
Kidney cancer
medicine.disease
SEER database
Clear cell renal cell carcinoma
medicine.anatomical_structure
030220 oncology & carcinogenesis
business
Subjects
Details
- ISSN :
- 14338726 and 07244983
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- World Journal of Urology
- Accession number :
- edsair.doi.dedup.....5d27e36f6726a3aef4855f938bbbef8c
- Full Text :
- https://doi.org/10.1007/s00345-020-03187-y